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文献詳細

雑誌文献

medicina60巻8号

2023年07月発行

文献概要

特集 浮腫と脱水—Q&Aで学ぶジェネラリストのための体液量異常診療 利尿薬の使い方と注意点

トルバプタンの使い方とその注意点

著者: 丑丸秀1 冨永直人1

所属機関: 1川崎市立多摩病院腎臓・高血圧内科

ページ範囲:P.1286 - P.1290

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◎トルバプタンの適応を十分検討したうえで,入院のもと,開始する.
◎トルバプタンの投与前後に尿量増加の程度,および血清ナトリウム(Na)濃度の絶対値およびその変化に関して,確認が必要である(特に,浸透圧性脱髄症候群の発症予防目的).
◎トルバプタンの効果に関する予測指標として確立したものはないが,尿浸透圧の低下は有用となり得る.

参考文献

1)Kinugawa K, et al:Impact of tolvaptan add-on treatment on patients with heart failure requiring long-term congestion management;A retrospective cohort study using a medical claim database in Japan. J Cardiol S0914-5087:00323-9, 2022
2)Konstam MA, et al:Effects of oral tolevaptan in patients hospitalized for worsening heart failure;The EVEREST Outcome Trial. JAMA 297:1319-1331, 2007
3)Konstam MA, et al:Short-term effects of tolvaptan in patients with acute heart failure and volume overload. J Am Coll Cardiol 69:1409-1419, 2017
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6)Inomata T, et al:Effects of additive tolvaptan vs. increased furosemide on heart failure with diuretic resistance and renal impairment-results from the K-STAR Study. Circ J 82:159-167, 2017
7)Kida K, et al:Efficacy of tolvaptan added to furosemide in heart failure patients with advanced kidney dysfunction;A pharmacokinetic and pharmacodynamic study. Clin Pharmacokinet 54:273-284, 2015
8)日本消化器病学会・日本肝臓学会(編):肝硬変診療ガイドライン2020(改訂第3版),南江堂,2020
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13)Hiramine Y, et al:Effect of tolvaptan on the prognosis of patients with hepatic ascites. Hepatol Res 49:765-777, 2019
14)Arima H, et al:Open-label, multicenter, dose-titration study to determine the efficacy and safety of tolvaptan in Japanese patients with hyponatremia secondary to syndrome of inappropriate secretion of antidiuretic hormone. Endocr J 68:17-29, 2021
15)Harris PC, Torres VE:Genetic mechanisms and signaling pathways in autosomal dominant polycystic kidney disease. J Clin Invest 124:2315-2324, 2014
16)Torres VE, et al:Tolvaptan in patients with autosomal dominant polycystic kidney disease. N Engl J Med 367:2407-2418, 2012
17)難治性腎障害に関する調査研究班(編):エビデンスに基づく多発性囊胞腎(PKD)診療ガイドライン2020,東京医学社,2020
18)Imamura T, et al:Urine osmolality estimated using urine urea nitrogen, sodium and creatinine can effectively predict response to tolvaptan in decompensated heart failure patients. Circ J 77:1208-1213, 2013
19)Shimizu K, et al:Ratio of urine and blood urea nitrogen concentration predicts the response of tolvaptan in congestive heart failure. Nephrology(Carlton)20:405-412, 2015

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1189

印刷版ISSN:0025-7699

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