Novel Risk Score Efficiently Prevents Tolvaptan-Induced Hypernatremic Events in Patients With Heart Failure
| Autor: | Takayuki Inomata, Toshiyuki Shimakawa, Yoshiyuki Shibasaki, Naoki Sato, Koichiro Kinugawa, Moriyoshi Yasuda |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Population Tolvaptan 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Japan Internal medicine medicine Humans Urea 030212 general & internal medicine Adverse effect education Blood urea nitrogen Aged Heart Failure education.field_of_study Framingham Risk Score Hypernatremia business.industry Incidence Sodium General Medicine Odds ratio Middle Aged medicine.disease Heart failure Creatinine Potassium Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 82(5) |
| ISSN: | 1347-4820 |
| Popis: | Background It has been 7 years since tolvaptan was approved in Japan for the indication of heart failure in patients with volume overload; the drug can be used in patients with normonatremia. Hypernatremia was identified as a significant adverse event to be prevented.Methods and Results:We compiled and analyzed data from 3,349 patients over 5 years to identify patients at high risk of hypernatremia with tolvaptan treatment. The incidence of hypernatremia, defined as serum sodium ≥150 mEq/L, was 3.65%. Baseline serum sodium concentrations, serum potassium concentrations, blood urea nitrogen : creatinine ratio, initial tolvaptan dose, and age were identified as risk factors for hypernatremia. A hypernatremia risk score was developed using the odds ratios for these factors. The high-risk population was defined as patients with a risk score ≥17.80. Conclusions To prevent the occurrence of hypernatremic events in patients taking tolvaptan, we recommend a very low starting dose (i.e., 3.75 mg/day) in patients identified as being at high risk of hypernatremia using our new scoring process. |
| Databáze: | OpenAIRE |
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