Objective:To systematically review the efficacy and safety of tolvaptan for the patients with hyponatremia. Methods:Databases of china national knowledge infrastructure(CNKI)

wanfang

VIP

Pub Med

Web of Science

Springer were electronically searched for randomized controlled trials from 2000 to June 2015

which were about the efficacy and safety of tolvaptan for the hyponatremia patients. Two reviewers independently screened literature

extracted data according to the inclusion and exclusion criteria and assessed the methodological quality of the included studies by using Jadad scale. Then

Meta-analysis was performed using R3.1.3 software. Results:Fourteen trials involving 1 324 patients were included(tolvaptan group:678 patients;control group:646 patients).The results of Meta-analysis showed that tolvaptan group was more effective than control group in increasing the serum sodium concentration

WMD=3.33 mmol/L(90%CI=2.90-3.75

Z=12.95

P=0.000)

in serum sodium normal rate(RR=2.61

90%CI=2.13-3.21

Z=7.70

P=0.000);in urine output in 24 hours WMD=812.82 ml(90%CI=534.90-1 090.75

Z=4.81

P=0.000);in net fluid balance changes

WMD=750.54 ml(90%CI=464.44-1 036.63

Z=7.733

P=0.000). There was no significant difference in the adverse events and mortality between tolvaptan and control group and RR were respectively 0.99(90%CI=0.86-1.13

Z=-0.184

P=0.854)and 1.15(90%CI=0.78-1.69

Z=0.582

P=0.561). Conclusion:Tolvaptan significantly increases serum sodium concentration

serum sodium normal rate

urine output in 24 hours and net fluid balance changes without increasing the adverse events and mortality.