Nutritional status and long-term prognosis in patients with refractory hepatic ascites treated with tolvaptan

نویسندگان

  • Masaaki Shimada
  • Hiroaki Iwase
  • Noboru Hirashima
  • Nobumitsu Ryuge
  • Noboru Urata
چکیده

Objective: We evaluated whether nutritional status and long-term prognosis of patients with refractory hepatic ascites improved after treatment with tolvaptan. Methods: We retrospectively studied data for a total of 50 patients with hepatic ascites treated with tolvaptan from April 2011 to January 2016. Bloatedness was assessed by using the Japanese version of the support team assessment schedule before and after 3 weeks of treatment with tolvaptan. Changes in the controlling nutritional status (CONUT) and long-term prognosis were investigated. Results: Sixty-four percent of patients reported an improvement in bloatedness. The caloric intake and the CONUT score (from 8.4 ± 2.2 to 7.4 ± 2.8, P = 0.004) were both significantly improved after tolvaptan therapy. The CONUT score and muscle mass were significantly lower in non-responders. The responders showed a loss of bodyweight, reduction of bloatedness, increase in caloric intake, and improvement in the CONUT score, but the nutritional status did not improve in nonresponders. The long-term prognosis improved in responders compared with non-responders (mean survival time: 419 days vs. 212 days, P = 0.003). Conclusion: Tolvaptan therapy is useful for treating refractory hepatic ascites, and results in improved nutritional status and long-term prognosis. Correspondence to: Dr. Masaaki Shimada, Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, 4-1-1 Sannomaru Naka-ku, Nagoya 460-0001, Japan; Tel: 052-951-1111; Fax: 052-951-0664; E-mail: [email protected]

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Long-Term Administration and Outcomes of Tolvaptan for Hepatic Edema

Objective: Tolvaptan is an oral vasopressin V2 receptor antagonist that became available as therapy for decompensated hepatic cirrhosis-induced ascites in 2013. It has now been more than 3 years since hepatic edema was included in the indication. We investigated use of tolvaptan in our department, including long-term administration, discontinuation, and re-administration after discontinuation. ...

متن کامل

Efficacy of tolvaptan for the patients with advanced hepatocellular carcinoma

AIM To investigate the factors influenced the efficacy of tolvaptan (TLV) in liver cirrhosis. METHODS We retrospectively enrolled 61 consecutive patients with refractory hepatic ascites. All of them had been treated with furosemide and spironolactone before admission, and treated with TLV for 7 d in our hospital. The effect of TLV was defined by the rate of body weight loss, and the factors t...

متن کامل

Effectiveness of tolvaptan monotherapy and low-dose furosemide/tolvaptan combination therapy for hepatoprotection and diuresis in a rat cirrhotic model

Spironolactone and furosemide, which are used to treat ascites associated with decompensated cirrhosis, are ineffective in treating refractory ascites. Hence, combination therapy with tolvaptan, a vasopressin V2 receptor antagonist, has been approved in Japan. Tolvaptan monotherapy and combination therapy with furosemide inhibit fibrosis in cardiac remodeling; hence, we examined these therapies...

متن کامل

The treatment of vasopressin V2-receptor antagonists in cirrhosis patients with ascites: a meta-analysis of randomized controlled trials

BACKGROUND Ascites is the most common complication of cirrhosis. It may lead to the consequence of poor prognosis and the deterioration of quality of life. Asopressin V2 receptor antagonists is a kind of vaptans, and it has been proved to be effective in hyponatremia patients. We conducted a meta-analysis about treatment of vaptans in cirrhosis patients with ascites. METHODS Following our sel...

متن کامل

Long-Term Effects and Prognosis in Acute Heart Failure Treated with Tolvaptan: The AVCMA Trial

BACKGROUND Diuresis is a major therapy for the reduction of congestive symptoms in acute decompensated heart failure (ADHF) patients. We previously reported the efficacy and safety of tolvaptan compared to carperitide in hospitalized patients with ADHF. There were some reports of cardio- and renal-protective effects in carperitide; therefore, the purpose of this study was to compare the long-te...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2017