title: Predictive factors for responders to tolvaptan in fluid management after cardiovascular surgery.
abstract: OBJECTIVE
  To identify the predictive factors for responders to tolvaptan, a novel vasopressin type 2 receptor antagonist for fluid management after cardiovascular surgery.
  
  
  METHODS
  Between January 2013 and May 2014, 113 patients were treated with tolvaptan for fluid management after cardiovascular surgery. As indicators for the effects of tolvaptan, change in bodyweight during the tolvaptan administration period and correlations with perioperative factors were assessed. Thirty-one patients were administered tolvaptan at the first day after surgery (early tolvaptan group). In this group, urine volume during the 6 h before the initial tolvaptan administration was compared with that at 6 h after administration.
  
  
  RESULTS
  For all the patients, the change in bodyweight during the tolvaptan administration period significantly correlated with pre-operative serum creatinine (r = 0.19, p = 0.04) and albumin levels before tolvaptan administration (r = -0.29, p = 0.002). In the early tolvaptan group, the ratio of urine volume at 6 h before and 6 h after the initial tolvaptan administration significantly correlated with the pre-operative serum creatinine level (r = 0.43, p = 0.02), the serum albumin level before tolvaptan administration (r = -0.50, p = 0.004), and change in bodyweight (r = 0.38, p = 0.03).
  
  
  CONCLUSIONS
  In patients undergoing cardiovascular surgery, deteriorating renal function, increased bodyweight, and hypoalbuminemia were found to be predictive factors for responders to tolvaptan for postoperative fluid management.
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-Oka, Suita, Osaka, 565-0871, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kido
authors.affiliation: Department of Cardiovascular Surgery, Osaka Police Hospital, 10-31, Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishi
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-Oka, Suita, Osaka, 565-0871, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Toda
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-Oka, Suita, Osaka, 565-0871, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ueno
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-Oka, Suita, Osaka, 565-0871, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kuratani
authors.affiliation: Department of Cardiovascular Surgery, Osaka National Hospital, 2-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sakaki
authors.affiliation: Department of Cardiovascular Surgery, Osaka Police Hospital, 10-31, Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-Oka, Suita, Osaka, 565-0871, Japan. sawa-p@surg1.med.osaka-u.ac.jp.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000368:Aged; D065092:Antidiuretic Hormone Receptor Antagonists / Q000008:administration & dosage; D001552:Benzazepines / Q000008:administration & dosage*; D013504:Cardiovascular Surgical Procedures; D004305:Dose-Response Relationship, Drug; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000188:drug therapy*; D000077602:Tolvaptan; D016896:Treatment Outcome
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan
keywords: Cardiovascular surgery; Diuretics; Postoperative management; Tolvaptan