title: Successful conversion from thiazide to tolvaptan in a patient with stage d heart failure and chronic kidney disease before heart transplantation.
abstract: Chronic kidney disease (CKD) is often complicated with advanced heart failure because of not only renal congestion and decreased renal perfusion but also prolonged use of diuretics at higher doses, which sometimes results in hyponatremia. Preoperative CKD is known to be associated with poor prognosis after heart transplantation (HTx). We experienced a stage D heart failure patient with CKD and hyponatremia who was switched from trichlormethiazide to tolvaptan. His hyponatremia was normalized, and his renal function was improved after conversion to tolvaptan. In patients with stage D heart failure, it may be useful to administer tolvaptan with a concomitant reduction in the dose of diuretics in order to preserve renal function and avoid hyponatremia before HTx.
authors: Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Teruhiko
authors: T
authors: Imamura
authors: Koichiro
authors: K
authors: Kinugawa
authors: Naoko
authors: N
authors: Kato
authors: Shun
authors: S
authors: Minatsuki
authors: Hironori
authors: H
authors: Muraoka
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: Minoru
authors: M
authors: Ono
authors: Issei
authors: I
authors: Komuro
mesh_terms: D001552:Benzazepines / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D057915:Drug Substitution; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced / Q000188:drug therapy; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D012076:Renal Agents / Q000008:administration & dosage / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012720:Severity of Illness Index; D013318:Stroke Volume; D013995:Time; D000077602:Tolvaptan; D016896:Treatment Outcome; D014237:Trichlormethiazide / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D001552:Benzazepines; D012076:Renal Agents; D000077602:Tolvaptan; D014237:Trichlormethiazide