Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Circ J. 2013;77(5):1208-13. doi: 10.1253/circj.cj-12-1328. Epub 2013 Jan 12.
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.
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).
Response to TLV can be predicted using U-OSM, which can be estimated using urine urea nitrogen, sodium, and creatinine concentration data.
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。
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）。
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。
