Abstract | BACKGROUND AND OBJECTIVE: METHODS: We studied 43 patients with liver cirrhosis who received tolvaptan (7.5 mg/day) for refractory ascites. s-CKD was defined as an estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73 m2. Response to tolvaptan was defined as weight loss ≥ 1.5 kg in 7 days of treatment. RESULTS: Eighteen patients (42%) had s-CKD (s-CKD group), while the other 25 patients (58%) did not have s-CKD (n-CKD group). Rates of response to tolvaptan were similar: 68% in the n-CKD group and 56% in the s-CKD group. Urine volumes increased significantly from baseline to day 7 in both groups. Incidences of adverse events were also similar (P = 0.93). Mean eGFR did not decline even in the s-CKD group (27.3 ± 2.2 mL/min/1.73 m2 at baseline vs. 26.6 ± 2.3 mL/min/1.73 m2 on day 7; P = 0.9). The cumulative survival rate did not differ significantly between the n-CKD and s-CKD groups. In the s-CKD group, responders obtained a better prognosis than non-responders. CONCLUSIONS:
Tolvaptan significantly increased urine volumes similarly in patients with s-CKD and n-CKD without affecting renal function. As responders achieved a better prognosis, tolvaptan could be a good option to treat ascites in patients with cirrhosis and s-CKD.
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Authors | Yoshitaka Arase, Tatehiro Kagawa, Kota Tsuruya, Hirohiko Sato, Erika Teramura, Kazuya Anzai, Shunji Hirose, Ryuzo Deguchi, Koichi Shiraishi, Tetsuya Mine |
Journal | Clinical drug investigation
(Clin Drug Investig)
Vol. 39
Issue 1
Pg. 45-54
(Jan 2019)
ISSN: 1179-1918 [Electronic] New Zealand |
PMID | 30284699
(Publication Type: Journal Article)
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Chemical References |
- Antidiuretic Hormone Receptor Antagonists
- Tolvaptan
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antidiuretic Hormone Receptor Antagonists
(therapeutic use)
- Ascites
(drug therapy)
- Female
- Glomerular Filtration Rate
- Humans
- Liver Cirrhosis
(drug therapy)
- Male
- Middle Aged
- Renal Insufficiency, Chronic
(physiopathology)
- Retrospective Studies
- Tolvaptan
(therapeutic use)
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