TITLE:
The Effect of Loop Diuretics on Sarcopenia and Long-Term Prognosis in Patients with Refractory Hepatic Ascites Treated with Tolvaptan
AUTHORS:
Masaaki Shimada, Hiroaki Iwase, Noboru Hirashima, Masashi Saito, Hisashi Kondo, Noboru Urata, Satoshi Unita, Takashi Kondo, Daiki Tanaka, Takuya Tsunekawa
KEYWORDS:
Tolvaptan, Hepatic Ascites, Sarcopenia, Loop Diuretics, Long-Term Prognosis
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.8 No.6,
June
14,
2018
ABSTRACT: 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