使用尿尿素氮、钠和肌酐估算的尿渗透压能有效预测心力衰竭失代偿患者对托伐普坦的反应。
Urine osmolality estimated using urine urea nitrogen, sodium and creatinine can effectively predict response to tolvaptan in decompensated heart failure patients.
机构信息
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
出版信息
Circ J. 2013;77(5):1208-13. doi: 10.1253/circj.cj-12-1328. Epub 2013 Jan 12.
BACKGROUND
Urine osmolality (U-OSM) is valuable to predict response to tolvaptan (TLV) in decompensated heart failure patients, but measurement of U-OSM is not always available on site.
METHODS AND RESULTS
Data were collected from 66 hospitalized patients with decompensated heart failure who had received TLV at 3.75-15 mg/day. U-OSM, which was estimated using the following formula: 1.07×{2×[(urine sodium (mEq/L)]+[urine urea nitrogen (mg/dl)]/2.8+[urine creatinine (mg/dl)]×2/3}+16, was well correlated with the actual measurement (r=0.938, P<0.001). Criteria consisting of C1 (estimated baseline U-OSM>358 mOsm/L) and C2 (%decrease in estimated U-OSM>24% at 4-6 h after the first TLV dose) significantly discriminated responders from non-responders (P<0.05).
CONCLUSIONS
Response to TLV can be predicted using U-OSM, which can be estimated using urine urea nitrogen, sodium, and creatinine concentration data.
背景
尿渗透压（U-OSM）对于预测心力衰竭失代偿患者对托伐普坦（TLV）的反应很有价值，但 U-OSM 的测量并非总是在现场进行。
方法和结果
从 66 名接受 3.75-15mg/天 TLV 治疗的住院心力衰竭失代偿患者中收集数据。U-OSM 可使用以下公式估算：1.07×{2×[(尿钠（mEq/L）]+[尿尿素氮（mg/dl）]/2.8+[尿肌酐（mg/dl）]×2/3}+16，与实际测量值高度相关（r=0.938，P<0.001）。由 C1（估计基线 U-OSM>358 mOsm/L）和 C2（首次 TLV 剂量后 4-6 小时估计 U-OSM 下降>24%）组成的标准可显著区分应答者和无应答者（P<0.05）。
结论
可以使用 U-OSM 预测 TLV 的反应，U-OSM 可以使用尿尿素氮、钠和肌酐浓度数据进行估算。
Zotero 插件