Observational studyClinical and experimental nephrology2013
The effects of tolvaptan on patients with severe chronic kidney disease complicated by congestive heart failure.
Observational study in Clinical and experimental nephrology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 31 citations in OpenAlex.
- Dual Impact of Tolvaptan on Intracellular and Extracellular Water in Chronic Kidney Disease Patients with Fluid Retention.Internal medicine (Tokyo, Japan)Trial
- Kidney Function Trajectories with Tolvaptan in ADPKD Patients with CKD-G5.Kidney international reports · 2025Article
- Article
- Renal ultrasonography predicts worsening renal function in patients with heart failure under tolvaptan administration.ESC heart failure · 2024Article
- Effect of Tolvaptan in Patients with Chronic Kidney Disease Stage G5, and Impact of Concomitant Use of Thiazide Diuretics: A Retrospective Cohort Study.Drugs - real world outcomes · 2022Article
- Impact of serum albumin levels on the body fluid response to tolvaptan in chronic kidney disease patients.International urology and nephrology · 2019Article
- Impaired Renal Function May Not Negate the Efficacy of Tolvaptan in the Treatment of Cirrhotic Patients with Refractory Ascites.Clinical drug investigation · 2019Article
- Effects of tolvaptan in patients with chronic kidney disease and chronic heart failure.Clinical and experimental nephrology · 2017Observational
- The efficacy of tolvaptan in the perioperative management of chronic kidney disease patients undergoing open-heart surgery.Surgery today · 2017Article
- Clinical benefit of tolvaptan in patients with acute decompensated heart failure and chronic kidney disease.Heart and vessels · 2016Article
- Urine Aquaporin-2: A Promising Marker of Response to the Arginine Vasopressin Type-2 Antagonist, Tolvaptan in Patients with Congestive Heart Failure.International journal of molecular sciences · 2016Review
- Long-term effects of tolvaptan in patients requiring recurrent hospitalization for heart failure.Nagoya journal of medical science · 2015Article
- Management of severe hyponatremia: infusion of hypertonic saline and desmopressin or infusion of vasopressin inhibitors?The American journal of the medical sciences · 2014Review
- Dysnatremias in patients with kidney disease.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2014Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTolvaptan, a diuretic with a new mechanism of action, selectively binds to the vasopressin V2 receptor and inhibits reabsorption of water. Its effect on heart failure is proven, but its benefit for patients with chronic kidney disease (CKD) has not been not confirmed. In this study, we examined the effect of tolvaptan on patients with severe CKD.
methodsWe analyzed patients with stage 4 or higher CKD who had congestive heart failure that was resistant to existing diuretics. The patients were administered an initial tolvaptan dose of 7.5 mg/day. We assumed urine volume and urine osmolality to be the main effective endpoint and recorded free water clearance, serum osmolality, serum creatinine (Cr) level, and adverse events.
resultsThere was no instance of clinically significant hypernatremia. The urine volume increased significantly (P < 0.0001), as did the urine osmolality (P = 0.0053). Free water clearance showed a tendency to increase, although the difference was not statistically significant. The serum creatinine level did not change significantly, and there was no clear effect on renal function. However, in patients with stage 5 CKD, the serum creatinine level decreased significantly (n = 5, P = 0.0435). There were no adverse events.
conclusionWe confirmed that tolvaptan has a diuretic effect in patients with both severe CKD and congestive heart failure without causing either clinically significant hypernatremia or an adverse effect on renal function. Tolvaptan is an effective diuretic for patients with CKD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.