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

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]