Title |
Novel Risk Score Efficiently Prevents Tolvaptan-Induced Hypernatremic Events in Patients With Heart Failure
|
---|---|
Published in |
Circulation Journal, March 2018
|
DOI | 10.1253/circj.cj-17-0986 |
Pubmed ID | |
Authors |
Koichiro Kinugawa, Naoki Sato, Takayuki Inomata, Moriyoshi Yasuda, Yoshiyuki Shibasaki, Toshiyuki Shimakawa |
Abstract |
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. 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. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Japan | 10 | 22% |
United States | 1 | 2% |
Unknown | 35 | 76% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 45 | 98% |
Scientists | 1 | 2% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 30 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 5 | 17% |
Student > Ph. D. Student | 4 | 13% |
Lecturer | 3 | 10% |
Student > Doctoral Student | 3 | 10% |
Other | 3 | 10% |
Other | 5 | 17% |
Unknown | 7 | 23% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 11 | 37% |
Nursing and Health Professions | 2 | 7% |
Computer Science | 2 | 7% |
Agricultural and Biological Sciences | 1 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
Other | 1 | 3% |
Unknown | 12 | 40% |