Abstract:
BACKGROUNDS:Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan. METHODS:We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. RESULTS:Systolic (p = 0.045) and diastolic (p = 0.004) blood pressure, serum sodium level (p = 0.002), and negative water balance (p = 0.036) were significantly higher and serum potassium level (p = 0.026) was significantly lower on admission day in patients with hypernatremia (n = 22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p = 0.034). Among patients with serum potassium level ≤ 3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p = 0.004). CONCLUSION:In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8 mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.
journal_name
BMC Cardiovasc Disordjournal_title
BMC cardiovascular disordersauthors
Fukuoka H,Tachibana K,Shinoda Y,Minamisaka T,Inui H,Ueno K,Inoue S,Mine K,Ueda K,Hoshida Sdoi
10.1186/s12872-020-01751-3subject
Has Abstractpub_date
2020-10-29 00:00:00pages
467issue
1issn
1471-2261pii
10.1186/s12872-020-01751-3journal_volume
20pub_type
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pub_type: 杂志文章,meta分析
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