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Heart and Vessels
Erschienen in: Heart and Vessels 8/2021

12.02.2021 | Original Article

Long-term administration of tolvaptan ameliorates annual decline in estimated glomerular filtration rate in outpatients with chronic heart failure

verfasst von: Kazuhiro Nakao, Takeshi Horio, Ryutaro Yoshimura, Ryosuke Fujiwara, Yujiro Matsuoka, Go Yokouchi, Haruo Nakamura, Yuya Sakamoto, Kohei Fujimoto, Yasuhiro Izumiya, Minoru Yoshiyama, Noriaki Kasayuki

Erschienen in: Heart and Vessels | Ausgabe 8/2021

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Abstract

Protective effects of tolvaptan against worsening renal function in acute heart failure have been shown. However, long-term effects of its agent on renal function remain to be elucidated. The present study investigated retrospectively whether long-term treatment with tolvaptan exerts renoprotective effects in patients with chronic heart failure, by comparing serial changes in estimated glomerular filtration rate (eGFR) for years before and after tolvaptan administration. From 63 outpatients with chronic heart failure taking diuretics including tolvaptan, 34 patients whose eGFR levels were continuously measured for more than 6 months both before and after administration of tolvaptan (average dose, 7.8 mg/day at the end of the follow-up period) were selected as eligible for the present analyses. All eGFR values were separately plotted before and after the initiation of treatment with tolvaptan (except hospitalization periods) along the time course axis and the slope of the linear regression curve was calculated as an annual change in eGFR. The mean follow-up periods before and after tolvaptan administration were 1197 and 784 days (3.3 and 2.1 years), respectively. Changing rates of eGFR per year were significantly ameliorated after treatment with tolvaptan (mean ± SD, − 8.02 ± 9.35 to − 1.62 ± 5.09 mL/min/1.73m2 /year, P = 0.001). In echocardiographic parameters, inferior vena cava (IVC) diameter significantly decreased after tolvaptan administration, and the decrease in IVC diameter was correlated with the improvement of eGFR decline slope after administration of tolvaptan (P = 0.0075). This longitudinal observational study indicated that long-term treatment with tolvaptan ameliorated annual decline in eGFR in outpatients with chronic heart failure. Our findings suggest that tolvaptan has a protective effect against chronically worsening renal function in heart failure patients.
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Metadaten
Titel
Long-term administration of tolvaptan ameliorates annual decline in estimated glomerular filtration rate in outpatients with chronic heart failure
verfasst von
Kazuhiro Nakao
Takeshi Horio
Ryutaro Yoshimura
Ryosuke Fujiwara
Yujiro Matsuoka
Go Yokouchi
Haruo Nakamura
Yuya Sakamoto
Kohei Fujimoto
Yasuhiro Izumiya
Minoru Yoshiyama
Noriaki Kasayuki
Publikationsdatum
12.02.2021
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 8/2021
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-021-01801-6

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