The Effect of Loop Diuretics on Sarcopenia and Long-Term Prognosis in Patients with Refractory Hepatic Ascites Treated with Tolvaptan

• 作者: Daiki Tanaka Hiroaki Iwase Hisashi Kondo Masaaki Shimada Masashi Saito Noboru Hirashima Noboru Urata Satoshi Unita Takashi Kondo Takuya Tsunekawa
• 来源期刊: 肠胃病学期刊(英文)
• 学科: 医学
• 关键词: TOLVAPTAN HEPATIC ASCITES SARCOPENIA Loop DIURETICS Long-Term Prognosis
• 年，卷（期）: 2018,（6）
• 页码范围: 201-208
• 页数: 8页
• 分类号: R5

摘要

We investigated sarcopenia, focusing on the dose of loop diuretics used in 70 patients with refractory hepatic ascites treated with tolvaptan. Bloating improved in 68.5% of patients, as determined using the Japanese version of the Support Team Assessment Schedule. The psoas muscle index (PMI) was used to define sarcopenia. A statistically significant difference was observed in the PMI between patients receiving low-dose (3.6 ± 1.2 cm2/m2) and high-dose furosemide (3.1 ± 1.2 cm2/m2) before tolvaptan treatment (P = 0.048). The PMI increased from 3.2 ± 1.1 cm2/m2 to 3.5 ± 1.3 cm2/m2 (P = 0.002) in responders, but decreased from 3.4 ± 1.2 cm2/m2 to 3.0 ± 1.0 cm2/m2 (P = 0.106) in non-responders before and after tolvaptan treatment, respectively. The long-term prognosis improved in responders compared with non-responders (mean survival time: 646 days vs. 228 days, P < 0.001). Early introduction of tolvaptan treatment is necessary to prevent the progression of sarcopenia.