Comparison of the effects of tolvaptan and furosemide on renal water and sodium excretion in patients with heart failure and ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-06-22

AUTHORS

Naoto Tominaga, Keisuke Kida, Takayuki Inomata, Naoki Sato, Tohru Izumi, Yoshihiro J. Akashi, Yugo Shibagaki

ABSTRACT

BackgroundTolvaptan (TLV) is known to increase electrolyte-free water clearance. However, TLV actions on renal electrolytes including urine sodium (uNa) excretion and its consequences are less well understood. This subanalysis investigated the effect of add-on TLV compared to increased furosemide (FUR) on both electrolyte-free water and electrolyte clearance in patients with congestive heart failure (CHF) complicated by advanced chronic kidney disease (CKD).MethodsThe Kanagawa Aquaresis Investigators Trial of TLV on HF Patients with Renal Impairment (K-STAR) was a multicenter, open-labeled, randomized, and controlled prospective clinical study. Eighty-one Japanese patients with CHF and residual signs of congestion despite oral FUR treatment (≥ 40 mg/day) were recruited and randomly assigned to a 7-day add-on treatment with either ≤ 40 mg/day FUR or ≤ 15 mg/day TLV. Electrolyte-free water clearance, electrolyte osmolar clearance and electrolyte excretion were compared between the two groups before and after therapy.ResultsThe change (Δ) in electrolyte-free water clearance was significantly higher in the add-on TLV group than in the add-on FUR group. However, Δelectrolyte osmolar clearance was also higher in the add-on TLV group than in the increased FUR group. This was primarily because ΔuNa excretion was significantly higher in the add-on TLV group than in the increased FUR group, since Δurine potassium excretion was significantly lower in the add-on TLV group than in the increased FUR group.ConclusionsAdd-on TLV may increase both renal water and Na excretion in CHF patients with advanced CKD to a greater degree than increased FUR. More... »

PAGES

1395-1403

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10157-018-1603-1

DOI

http://dx.doi.org/10.1007/s10157-018-1603-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105067758

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29934667


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