{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:07:03Z","timestamp":1789834023282,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T00:00:00Z","timestamp":1578960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The prognosis of cirrhotic patients with hepatic edema is poor. Although several short\u2010term predictors of tolvaptan (novel diuretic agent) treatment for such patients have been reported, the factors related to long\u2010term survival are still unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 459 patients with hepatic edema enrolled in a retrospective, multicenter collaborative study, we analyzed 407 patients who received tolvaptan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients consisted of 266 men and 141 women, with the median age of 68\u00a0years (range, 28\u201393\u00a0years). The frequency of short\u2010term responders to tolvaptan was 59.7% (243\/407). In the Cox regression analysis, short\u2010term response to tolvaptan, low average dosages of furosemide and spironolactone during tolvaptan treatment, Child\u2013Pugh classification A and B, and absence of hepatocellular carcinoma were independent factors contributed to 1\u2010year survival. The 1\u2010year and long\u2010term cumulative survival rates in short\u2010term responders were significantly higher than those in non\u2010responders (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.011 and 0.010, respectively). Using a receiver operating characteristic curve analysis, the optimal cut\u2010off values of average daily dosages of furosemide and spironolactone for predicting 1\u2010year survival were 19 and 23\u00a0mg\/day, respectively. The long\u2010term cumulative survival rates in patients who received a mean dosage of spironolactone &lt;\u00a023\u00a0mg\/day during tolvaptan treatment were significantly higher than those receiving a mean dosage of \u2265\u00a023\u00a0mg\/day (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study suggests that the short\u2010term response to tolvaptan and low dosages of conventional diuretics during tolvaptan treatment might improve the 1\u2010year and long\u2010term survival rates in cirrhotic patients with hepatic edema.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14965","type":"journal-article","created":{"date-parts":[[2019,12,28]],"date-time":"2019-12-28T00:40:15Z","timestamp":1577493615000},"page":"1229-1237","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Analysis of factors associated with the prognosis of cirrhotic patients who were treated with tolvaptan for hepatic edema"],"prefix":"10.1111","volume":"35","author":[{"given":"Masanori","family":"Atsukawa","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihito","family":"Tsubota","sequence":"additional","affiliation":[{"name":"Core Research Facilities The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Takaguchi","sequence":"additional","affiliation":[{"name":"Department of Hepatology Kagawa Prefectural Central Hospital  Takamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Ogaki Municipal Hospital  Ogaki 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