title: Urine osmolality estimated using urine urea nitrogen, sodium and creatinine can effectively predict response to tolvaptan in decompensated heart failure patients.
abstract: BACKGROUND
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Response to TLV can be predicted using U-OSM, which can be estimated using urine urea nitrogen, sodium, and creatinine concentration data.
authors: Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Teruhiko
authors: T
authors: Imamura
authors: Koichiro
authors: K
authors: Kinugawa
authors: Shun
authors: S
authors: Minatsuki
authors: Hironori
authors: H
authors: Muraoka
authors: Naoko
authors: N
authors: Kato
authors: Toshiro
authors: T
authors: Inaba
authors: Hisataka
authors: H
authors: Maki
authors: Taro
authors: T
authors: Shiga
authors: Masaru
authors: M
authors: Hatano
authors: Atsushi
authors: A
authors: Yao
authors: Shunei
authors: S
authors: Kyo
authors: Issei
authors: I
authors: Komuro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines / Q000627:therapeutic use*; D015415:Biomarkers / Q000652:urine; D016009:Chi-Square Distribution; D003404:Creatinine / Q000652:urine*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009584:Nitrogen / Q000652:urine*; D009994:Osmolar Concentration; D012189:Retrospective Studies; D012964:Sodium / Q000652:urine*; D013997:Time Factors; D000077602:Tolvaptan; D016896:Treatment Outcome; D014508:Urea / Q000652:urine*
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D015415:Biomarkers; D006727:Hormone Antagonists; D000077602:Tolvaptan; D014508:Urea; D012964:Sodium; D003404:Creatinine; D009584:Nitrogen