A Case With Recovery of Response to Tolvaptan Associated With Remission of Acute Kidney Injury and Increased Urine Osmolality
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- Imamura Teruhiko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Kinugawa Koichiro
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
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- Kato Naoko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Minatsuki Shun
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Muraoka Hironori
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Inaba Toshiro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Maki Hisataka
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Shiga Taro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Hatano Masaru
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Hosoya Yumiko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Takahashi Masao
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Yao Atsushi
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Kyo Shunei
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
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- Ono Minoru
- Department of Cardiothoracic Surgery, Graduate School of Medicine, The University of Tokyo
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- 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
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- International Heart Journal
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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