Abstract: Objective To evaluate the efficacy and safety of tolvaptan in treating refractory ascites and hyponatremia due to cirrhosis compared with conventional therapy. Methods A total of 62 cases of liver cirrhosis with refractory ascites and hyponatremia were randomly divided into the tolvaptan group and routine diuretic group, which were given a daily dose of 15mg tolvaptan tablets or conventional diuretics, respectively. The observation points were 1-day before treatment(baseline), day 4 and day 7 during the treatment. Biochemical indicators(e.g., serum sodium, chlorine, potassium, carbon dioxide combining power), liver function(e.g., alanine aminotransferase and total bilirubin), renal function(e.g., urea nitrogen, carbon dioxide combining power and glomerular filtration rate), urine output, abdominal circumference and body mass index were recorded and compared. Results On day 4 and day 7, the averages serum sodium in the tolvaptan group were(132.8±6.3)mmol/L and(133.3±6.9)mmol/L, which were significantly higher than those in the routine diuretic group ［(128.8±6.0)mmol/L and(129.4±6.6)mmol/L)］,(P<0.05). The average urine volume in the tolvaptan group was remarkably higher than that in the routine diuretic group(P<0.05). The average body weight and abdominal circumference of the tolvaptan group were markedly less than those of the routine diuretic group(P<0.05). There were no statistically significant differences in liver function, renal function, blood pressure and heart rate before and after treatment in both groups(P>0.05). Conclusion Tolvaptan can effectively correct the refractory ascites and hyponatremia, increase urine volume and improve liquid equilibrium of patients with liver cirrhosis without damaging liver and kidney function.

Key words: Tolvaptan, Refractory ascites, Hyponatremia, Cirrhosis