Peak Lag Between Plasma Vasopressin and Urine Aquaporin-2 Following Cardiac Surgery

Tolvaptan, a vasopressin type-2 receptor antagonist, is utilized to ameliorate fluid retention following cardiac surgery. However, the optimal timing of tolvaptan administration considering novel biomarkers remains unknown. We prospectively included patients who underwent surgery between 2016 and 2020. measured perioperative trends free water reabsorption mediators including plasma arginine urine aquaporin-2. A total 20 (68 [60, 75] years old, 18 men) were included. Urine volume decreased gradually after initial 3 hours The level increased significantly with peak at postoperative 6 hours, whereas aquaporin-2 later delayed 12 hours. As result, relative level, which represents activity collecting ducts indicates predicted responses tolvaptan, was minimum Tolvaptan immediately might not be recommended given transient refractoriness probably due stunning kidney ducts.