| Renal effects of conivaptan, furosemide, and the combination in patients with chronic heart failure. | |
| | |
MedLine Citation:
|
PMID: 22123359 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
BACKGROUND: Loop diuretics, though often effective for treating congestion, have significant limitations. Discovering ways to limit exposure to loop diuretics while achieving effective decongestion is an important goal of current clinical research in heart failure (HF). Vasopressin antagonists are effective in removing large amounts of water, but not salt, in HF. Few data exist about the detailed renal and hormonal effects of these agents compared with or in combination with loop diuretics. This study investigated the renal and neurohormonal effects of loop diuretics, the mixed vasopressin antagonist conivaptan, and the combination in patients with chronic stable HF. METHODS AND RESULTS: In 8 patients with chronic stable HF on standard medical treatment, heart rate, arterial pressure, systemic vascular resistance, and cardiac output (the latter 2 by using impedance cardiography), as well as glomerular filtration rate (iothalamate clearance), renal blood flow (para-aminohippurate clearance), urinary volumes and urinary sodium, plasma catecholamines, renin activity, arginine vasopressin, and B-type natriuretic peptide were assessed before and at hourly intervals for 4 hours after receiving furosemide, conivaptan, or the combination on 3 different study days at a minimum of 1-week intervals. There were no significant effects of conivaptan, furosemide, or the combination on any hemodynamic variable, neurohormonal level, renal blood flow, or glomerular filtration rate. Conivaptan and furosemide similarly increased urine volumes; the effect of the combination was significantly greater. Furosemide, but not conivaptan, increased urinary sodium excretion, and the combination was significantly greater than after furosemide alone. CONCLUSIONS: Without adversely affecting important hemodynamic variables, neurohormones, renal blood flow, or glomerular filtration rate, conivaptan significantly augmented both the diuretic and the natriuretic response to furosemide in patients with chronic HF. These results may have implications for the design of furosemide-sparing regimens in the treatment of acute HF. |
| | |
Authors:
|
Steven R Goldsmith; David T Gilbertson; Shari A Mackedanz; Suzanne K Swan |
Related Documents
:
|
22269249 - Comparison of renal resistive index among patients with type 2 diabetes with differen... 21919969 - Extracorporeal life support as a bridge to high-urgency heart transplantation. 22065249 - Challenges in lung transplantation. 22260509 - Ngal as an early biomarker of kidney disease in joubert syndrome: three brothers compared. 21781649 - Influence of renal impairment on the pharmacokinetics of oral roflumilast: an open-labe... 22228349 - Evolution of a ureteric stone from the renal pelvis to the ureter on skeletal scintigra... 1246389 - Recovery after prolonged anuria following septic abortion. 3332179 - Invasive trichosporon cutaneum infection: an increasing problem in immunosuppressed pat... 18418349 - Expression and function of the delta-1/notch-2/hes-1 pathway during experimental acute ... |
Publication Detail:
|
Type: Journal Article Date: 2011-10-06 |
Journal Detail:
|
Title: Journal of cardiac failure Volume: 17 ISSN: 1532-8414 ISO Abbreviation: J. Card. Fail. Publication Date: 2011 Dec |
Date Detail:
|
Created Date: 2011-11-29 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9442138 Medline TA: J Card Fail Country: United States |
Other Details:
|
Languages: eng Pagination: 982-9 Citation Subset: IM |
Copyright Information:
|
Copyright © 2011. Published by Elsevier Inc. |
Affiliation:
|
Cardiology Division, Hennepin County Medical Center, Minneapolis, Minnesota. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A Multicenter, Randomized, Double-blind, Placebo-controlled Study of Tolvaptan Monotherapy Compared ...
Next Document: Clinical characteristics and outcomes of patients with improvement in renal function during the trea...