A Case With Recovery of Response to Tolvaptan Associated With Remission of Acute Kidney Injury and Increased Urine Osmolality

  • Imamura Teruhiko
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Kinugawa Koichiro
    Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
  • Kato Naoko
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Minatsuki Shun
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Muraoka Hironori
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Inaba Toshiro
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Maki Hisataka
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Shiga Taro
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Hatano Masaru
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Hosoya Yumiko
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Takahashi Masao
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Yao Atsushi
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
  • Kyo Shunei
    Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
  • Ono Minoru
    Department of Cardiothoracic Surgery, Graduate School of Medicine, The University of Tokyo
  • Komuro Issei
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo

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抄録

Tolvaptan (TLV), a vasopressin type 2 receptor antagonist, has been demonstrated to be effective in patients with decompensated heart failure (HF) refractory to incremental doses of diuretics, but the responsiveness has not always been predictable. We have recently proposed that urine osmolality (U-OSM) is a valuable parameter for the prediction of responses to TLV, because U-OSM reflects the activity of the collecting ducts, where TLV plays its unique role. Acute kidney injury (AKI) is often associated with severe tubular dysfunction, including the collecting ducts, and in such cases a response to TLV may not be expected. We here experienced a patient with HF and AKI in whom TLV was not effective during AKI. We also observed recovery of responsiveness to TLV along with remission of AKI as well as increased U-OSM later on. We believe that this is the first report on the reversibility of the TLV response in relation to U-OSM.

収録刊行物

  • International Heart Journal

    International Heart Journal 54 (2), 115-118, 2013

    一般社団法人 インターナショナル・ハート・ジャーナル刊行会

被引用文献 (5)*注記

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参考文献 (19)*注記

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