title: Close correlation between urinary sodium excretion and response to tolvaptan in liver cirrhosis patients with ascites.
abstract: OBJECTIVE
  To assess the correlation between response to tolvaptan and treatment-related factors in liver cirrhosis patients.
  
  
  METHODS
  This single-center retrospective study was carried out at Shonan Kamakura General Hospital in Kanagawa, Japan, between October 2013 and September 2015. Forty-three liver cirrhosis patients (mean age, 65.7 years) with insufficient responses to conventional diuretics for at least 7 days were enrolled. All patients received oral tolvaptan (7.5 mg/day for 7 days) and guideline-directed medical therapy including sodium intake restrictions. A responder to tolvaptan was defined as a patient having a ≥2-kg decrease in body weight 1 week after commencing drug treatment, and a non-responder was defined as a patient not losing ≥2 kg in body weight 1 week after commencing treatment. We investigated the correlation of change in body weight for 1 week after drug administration compared to baseline clinical characteristics.
  
  
  RESULTS
  The mean body weight change from the baseline on the final dosing day was -2.47 ± 3.34 kg (P < 0.0001). There were 20 (46.5%) responders to tolvaptan. Urinary sodium and volume excretion was higher in responders than in non-responders (108.2 ± 70.5 vs 42.6 ± 36.7, P = 0.0003; 1462.8 ± 625.7 vs 960.9 ± 600.6, P = 0.0073). Logistic regression analyses for responders to tolvaptan were carried out, and independent correlation of the responders was urinary sodium excretion (P = 0.0114; hazard ratio, 0.9418; 95% confidence interval, 0.8768-0.9896) in the multivariate analyses.
  
  
  CONCLUSIONS
  In decompensated liver cirrhosis patients, urinary excretion sodium showed good correlation with tolvaptan response.
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.|Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Uojima
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kinbara
authors.affiliation: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Hidaka
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Sung
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Masachika
authors.initials: M
authors.lastname: Ichida
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Tokoro
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Sakue
authors.initials: S
authors.lastname: Masuda
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takizawa
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sasaki
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Koizumi
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Egashira
authors.affiliation: Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kako
keywords: ascites; diuretic effect; hepatic edema; liver cirrhosis; tolvaptan