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Successful conversion from thiazide to tolvaptan in a patient with stage d heart failure and chronic kidney disease before heart transplantation.

Abstract
Chronic kidney disease (CKD) is often complicated with advanced heart failure because of not only renal congestion and decreased renal perfusion but also prolonged use of diuretics at higher doses, which sometimes results in hyponatremia. Preoperative CKD is known to be associated with poor prognosis after heart transplantation (HTx). We experienced a stage D heart failure patient with CKD and hyponatremia who was switched from trichlormethiazide to tolvaptan. His hyponatremia was normalized, and his renal function was improved after conversion to tolvaptan. In patients with stage D heart failure, it may be useful to administer tolvaptan with a concomitant reduction in the dose of diuretics in order to preserve renal function and avoid hyponatremia before HTx.
AuthorsTeruhiko Imamura, Koichiro Kinugawa, Naoko Kato, Shun Minatsuki, Hironori Muraoka, Toshiro Inaba, Hisataka Maki, Taro Shiga, Masaru Hatano, Atsushi Yao, Shunei Kyo, Minoru Ono, Issei Komuro
JournalInternational heart journal (Int Heart J) Vol. 54 Issue 1 Pg. 48-50 ( 2013) ISSN: 1349-3299 [Electronic] Japan
PMID23428925 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Benzazepines
  • Renal Agents
  • Tolvaptan
  • Trichlormethiazide
Topics
  • Benzazepines (administration & dosage, adverse effects)
  • Dose-Response Relationship, Drug
  • Drug Substitution
  • Heart Failure (complications, diagnosis, physiopathology, surgery)
  • Heart Transplantation (adverse effects, methods)
  • Humans
  • Hyponatremia (chemically induced, drug therapy)
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Postoperative Complications (prevention & control)
  • Preoperative Care (methods)
  • Renal Agents (administration & dosage, adverse effects)
  • Renal Insufficiency, Chronic (complications, diagnosis, drug therapy, physiopathology)
  • Severity of Illness Index
  • Stroke Volume
  • Time
  • Tolvaptan
  • Treatment Outcome
  • Trichlormethiazide (administration & dosage, adverse effects)

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