Evidence map›Paper›PMID 29154417›Full record

ArticleESC heart failure2017

Impact of chronic kidney disease on the diuretic response of tolvaptan in acute decompensated heart failure.

Shuntaro Ikeda, Kiyotaka Ohshima, Shigehiro Miyazaki, Hisaki Kadota, Hideaki Shimizu, Akiyoshi Ogimoto, Mareomi Hamada

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Cardiorenal syndrome: evolving concepts and pediatric knowledge gaps.Pediatric nephrology (Berlin, Germany) · 2025
    Review
  3. Article
  4. Article
  5. Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Review
  13. Effects of tolvaptan on renal function in chronic kidney disease patients with volume overload.International journal of nephrology and renovascular disease · 2018
    Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Shuntaro IkedaDepartment of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime, 798-8510, Japan.
Kiyotaka OhshimaDepartment of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime, 798-8510, Japan.
Shigehiro MiyazakiDepartment of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime, 798-8510, Japan.
Hisaki KadotaDepartment of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime, 798-8510, Japan.
Hideaki ShimizuDepartment of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime, 798-8510, Japan.
Akiyoshi OgimotoDepartment of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime, 798-8510, Japan.
Mareomi HamadaDepartment of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime, 798-8510, Japan.
Uwajima City Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThis study investigated the relationship between the initial diuretic response to tolvaptan and clinical predictors for tolvaptan responders in patients with acute decompensated heart failure (ADHF). METHODS AND

resultsPatients (153) with ADHF (clinical scenario 2 or 3 with signs of fluid retention) who were administered tolvaptan were enrolled. Tolvaptan (15 or 7.5 mg) was administered for at least 7 days to those patients in whom fluid retention was observed even after standard treatment. The maximum urine volume immediately after tolvaptan administration showed good correlations with the ejection fraction and estimated glomerular filtration rate that were independent predictors of the urine volume (UV) responders (≥1500 mL increase in urine volume). The diuretic response (in terms of maximum diuresis) diminished with advancing chronic kidney disease (CKD) stage and concomitant deterioration of the renal function. Furthermore, advanced CKD was a significant negative predictor for the body weight (BW) responders (2.0% decrease in the body weight within 1 week after starting tolvaptan). As compared with non-CKD, the presence of advanced CKD predicts poor diuretic response for both UV and BW responders.

conclusionsThe diuretic response following tolvaptan administration gradually diminished with progressive deterioration of the CKD stage. Worsening renal function was not observed. Tolvaptan is effective in treating CS2 or CS3 ADHF patients who present fluid retention and congestion, suggesting its potential efficacy for fluid management in the ADHF patients with CKD without worsening the renal function.

Indexed as

Acute DiseaseAgedAntidiuretic Hormone Receptor AntagonistsBenzazepinesDisease ProgressionDiuresisDose-Response Relationship, DrugFemaleFollow-Up StudiesGlomerular Filtration RateHeart FailureHumansMaleRenal Insufficiency, ChronicRetrospective StudiesTolvaptanAntidiuretic Hormone Receptor AntagonistsBenzazepinesTolvaptanAcute decompensated heart failureChronic kidney diseaseDiuretic responseTolvaptan

Identifiers

PMID29154417
PMCPMC5695178
OpenAlexW2734738746

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

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.