title: Urine Aquaporin-2: A Promising Marker of Response to the Arginine Vasopressin Type-2 Antagonist, Tolvaptan in Patients with Congestive Heart Failure.
abstract: Aquaporin-2, a member of the aquaporin family, is an arginine vasopressin-regulated water channel expressed in the renal collecting duct, and a promising marker of the concentrating and diluting ability of the kidney. The arginine vasopressin type-2 antagonist, tolvaptan, is a new-generation diuretic; it is especially indicated in patients with decompensated heart failure refractory to conventional diuretics. However, the ideal responders to tolvaptan have not yet been identified, and non-responders experience worse clinical courses despite treatment with tolvaptan. Urine aquaporin-2 has recently been demonstrated as a promising predictor of response to tolvaptan. We here validated aquaporin-2-guided tolvaptan therapy in patients with decompensated heart failure. Long-term efficacy of tolvaptan treatment in the responders defined by aquaporin-2 needs to be validated in the future prospective study.
authors.affiliation: Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan. te.imamu@gmail.com.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Imamura
authors.affiliation: Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan. kinugawa-tky@umin.ac.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
mesh_terms: D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use*; D051399:Aquaporin 2 / Q000652:urine*; D001552:Benzazepines / Q000627:therapeutic use*; D015415:Biomarkers / Q000652:urine; D006333:Heart Failure / Q000188:drug therapy / Q000652:urine*; D006801:Humans; D000077602:Tolvaptan
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D051399:Aquaporin 2; D001552:Benzazepines; D015415:Biomarkers; D000077602:Tolvaptan
keywords: chronic kidney disease; congestion; heart failure; hyponatremia