Section 57
Chapter 56,788

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

Imamura, T.; Kinugawa, K.; Minatsuki, S.; Muraoka, H.; Kato, N.; Inaba, T.; Maki, H.; Shiga, T.; Hatano, M.; Yao, A.; Kyo, S.; Komuro, I.

Circulation Journal Official Journal of the Japanese Circulation Society 77(5): 1208-1213


ISSN/ISBN: 1347-4820
PMID: 23318562
DOI: 10.1253/circj.cj-12-1328
Accession: 056787465

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

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