Urine osmolality estimated using urine urea nitrogen, sodium and creatinine can effectively predict response to tolvaptan in decompensated heart failure patients.

Abstract

BACKGROUND:

Urine osmolality (U-OSM) is valuable to predict response to tolvaptan (TLV) in decompensated heart failure patients, but measurement of U-OSM is not always available on site.

METHODS AND RESULTS:

Data were collected from 66 hospitalized patients with decompensated heart failure who had received TLV at 3.75-15 mg/day. U-OSM, which was estimated using the following formula: 1.07×{2×[(urine sodium (mEq/L)]+[urine urea nitrogen (mg/dl)]/2.8+[urine creatinine (mg/dl)]×2/3}+16, was well correlated with the actual measurement (r=0.938, P<0.001). Criteria consisting of C1 (estimated baseline U-OSM>358 mOsm/L) and C2 (%decrease in estimated U-OSM>24% at 4-6 h after the first TLV dose) significantly discriminated responders from non-responders (P<0.05).

CONCLUSIONS:

Response to TLV can be predicted using U-OSM, which can be estimated using urine urea nitrogen, sodium, and creatinine concentration data. 

• Authors: Teruhiko Imamura, Koichiro Kinugawa, Shun Minatsuki, Hironori Muraoka, Naoko Kato, Toshiro Inaba, Hisataka Maki, Taro Shiga, Masaru Hatano, Atsushi Yao, Shunei Kyo, Issei Komuro
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 77 Issue 5 Pg. 1208-13 ( 2013) ISSN: 1347-4820 [Electronic] Japan
• PMID: 23318562 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antidiuretic Hormone Receptor Antagonists
• Benzazepines
• Biomarkers
• Hormone Antagonists
• Tolvaptan
• Urea
• Sodium
• Creatinine
• Nitrogen

Topics

• Aged
• Aged, 80 and over
• Antidiuretic Hormone Receptor Antagonists
• Benzazepines (therapeutic use)
• Biomarkers (urine)
• Chi-Square Distribution
• Creatinine (urine)
• Female
• Heart Failure (diagnosis, drug therapy, physiopathology, urine)
• Hormone Antagonists (therapeutic use)
• Hospitalization
• Humans
• Male
• Middle Aged
• Models, Biological
• Nitrogen (urine)
• Osmolar Concentration
• Retrospective Studies
• Sodium (urine)
• Time Factors
• Tolvaptan
• Treatment Outcome
• Urea (urine)