Arginine Vasopressin as an Important Mediator of Fluctuations in the Serum Creatinine Concentration Under Decongestion Treatment in Heart Failure Patients

Hajime Kataoka

doi:10.1253/circrep.cr-21-0005

May 17, 2021Circulation ReportsOpen Access

Arginine Vasopressin as an Important Mediator of Fluctuations in the Serum Creatinine Concentration Under Decongestion Treatment in Heart Failure Patients

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Why the study?

The mechanism underlying serum creatinine fluctuations in heart failure patients remains unclear.

Are fluctuations in serum creatinine under decongestion therapy mediated by changes in plasma arginine vasopressin in patients with acute heart failure?

Structured PICO

Are fluctuations in serum creatinine under decongestion therapy mediated by changes in plasma arginine vasopressin in patients with acute heart failure?

P

Population

26 patients with acute heart failure recovering from worsening HF, mean age 81.2±12 years, 50% male, Japan-based. Key inclusion: acute HF undergoing a neurohormonal study. Key exclusion: cardiogenic shock, clinical diagnosis of acute coronary syndrome, or known advanced renal disease (SCr >3.0 mg/dL).

I

Intervention

Decongestion therapy (conventional therapy with a combination of loop diuretics, aldosterone blockade, thiazide diuretics, an oral vasopressin antagonist, acetazolamide, and/or inotropic drugs administered orally and/or intravenously) for mean 25.2±17 days.

O

Outcome

Mediators of serum creatinine (SCr) fluctuations under diuretic treatment, specifically the correlation between changes in SCr and changes in plasma arginine vasopressin (AVP) and other biomarkers.surrogate

Plasma arginine vasopressin appears to be a physiologically important mediator of serum creatinine fluctuations during decongestion therapy in heart failure patients, suggesting that creatinine changes may reflect hemodynamic shifts rather than intrinsic renal injury.

Limitations

cross-sectional observational study and should be considered as hypothesis generating
population of patients with mild-to-moderate HF
small-sized retrospective observational study with a selection bias due to data availability

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Implication

SCr fluctuations during AHF decongestion may reflect AVP-mediated hemodynamics; leaves open causal mediation and therapeutic targeting.

Abstract

Background:The mechanism underlying serum creatinine (SCr) fluctuations in heart failure (HF) patients remains unclear. This study examined mediators of SCr fluctuations under diuretic treatment in HF patients.

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Cite This Study

Hajime Kataoka (2021) studied this question.

synapsesocial.com/papers/6a090a0929af591ab70174e3 https://doi.org/10.1253/circrep.cr-21-0005

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Arginine Vasopressin as an Important Mediator of Fluctuations in the Serum Creatinine Concentration Under Decongestion Treatment in Heart Failure Patients

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Structured PICO

Limitations

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Implication

Abstract

Discussion

Cite This Study

Arginine Vasopressin as an Important Mediator of Fluctuations in the Serum Creatinine Concentration Under Decongestion Treatment in Heart Failure Patients

Figures

Structured PICO

Limitations

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Implication

Abstract

Discussion

Cite This Study

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