ArticlePloS one2017
Prediction of diuretic response to tolvaptan by a simple, readily available spot urine Na/K ratio.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 27 citations in OpenAlex.
- Tolvaptan treatment improves survival of cirrhotic patients with ascites and hyponatremia.BMC gastroenterology · 2018Trial
- Vaptans: A Narrative Review of Pharmacokinetics, Pharmacogenetics, and Clinical Applications.Cells · 2026Review
- [Research progress of tolvaptan in the treatment of refractory ascites in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Review
- Tolvaptan and the role of kidney aquaporin-2 abundance in managing volume overload in patients with CKD.Clinical kidney journal · 2024Article
- Neutrophil gelatinase-associated lipocalin predicts the efficacy of tolvaptan for ascites in patients with liver cirrhosis.Journal of gastroenterology · 2023Article
- Prediction factors of tolvaptan effectiveness in patients with refractory ascites complicated with hepatocellular carcinoma.European journal of gastroenterology & hepatology · 2021Article
- Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan.International journal of molecular sciences · 2021Review
- Impact of acute kidney injury on prognosis and the effect of tolvaptan in patients with hepatic ascites.Journal of gastroenterology · 2021Article
- Durable response without recurrence to Tolvaptan improves long-term survival.Journal of gastroenterology · 2020Article
- Development of objective indicators for quantitative analysis of sodium intake: the sodium to potassium ratio of second-void urine is correlated with 24-hour urinary sodium excretion.Nutrition research and practice · 2020Article
- 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
- Association between the Serum Sodium Levels and the Response to Tolvaptan in Liver Cirrhosis Patients with Ascites and Hyponatremia.Internal medicine (Tokyo, Japan) · 2018Observational
- Differentiating Medicated Patients Suffering from Major Depressive Disorder from Healthy Controls by Spot Urine Measurement of Monoamines and Steroid Hormones.International journal of environmental research and public health · 2018Article
- Tolvaptan is effective in treating patients with refractory ascites due to cirrhosis.Biomedical reports · 2017Article
Corrections and comments
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Authors and funding
17 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTolvaptan is vasopressin type 2 receptor antagonist that inhibits water reabsorption. It is used in combination with standard diuretics to treat ascites unresponsive to standard diuretic therapy or hyponatremia because of liver cirrhosis. This study evaluated the effectiveness and safety of tolvaptan in clinical practice and aimed to determine the factors related to its effectiveness.
methodsTolvaptan was administered to 88 consecutive cirrhotic patients with ascites unresponsive to standard diuretic therapy. An effective treatment response was a ≥2% reduction in body weight on day 7. The association of patient pretreatment characteristics with therapeutic effects was analyzed.
resultsMean weight reduction on day 7 of tolvaptan therapy was -2.9% ± 3.2%, and treatment was effective in 52% of patients. Multivariate analysis revealed that spot urine Na/K ratio ≥2.5 at baseline was the only factor independently related to therapeutic effect, with an odds ratio of 7.85 (95% confidence interval 2.64-23.40, p = 0.0002). Weight reduction percentage on day 7 was -4.0% ± 2.8% in patients with spot urine Na/K ≥2.5, which was significantly greater than the 0.7% ± 2.7% loss in those with urine Na/K < 2.5 (p < 0.05). A spot urine Na/K ratio ≥2.5 had a sensitivity of 85% and specificity of 60% for predicting effective treatment. No adverse events of treatment led to treatment discontinuation.
conclusionsBaseline spot urine Na/K was predictive of an effective response to tolvaptan therapy. It is simple to perform and readily available and might serve as an indicator of optimal timing of tolvaptan administration in patients with inadequate response to conventional Na diuretic therapy.
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