%0 Journal Article
%T The Effect of Loop Diuretics on Sarcopenia and Long-Term Prognosis in Patients with Refractory Hepatic Ascites Treated with Tolvaptan
%A Masaaki Shimada
%A Hiroaki Iwase
%A Noboru Hirashima
%A Masashi Saito
%A Hisashi Kondo
%A Noboru Urata
%A Satoshi Unita
%A Takashi Kondo
%A Daiki Tanaka
%A Takuya Tsunekawa
%J Open Journal of Gastroenterology
%P 201-208
%@ 2163-9469
%D 2018
%I Scientific Research Publishing
%R 10.4236/ojgas.2018.86022
%X 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 ¡À 1.2 cm<sup>2</sup>/m<sup>2</sup>) and high-dose furosemide (3.1 ¡À 1.2 cm<sup>2</sup>/m<sup>2</sup>) before tolvaptan treatment (P = 0.048). The PMI increased from 3.2 ¡À 1.1 cm<sup>2</sup>/m<sup>2</sup> to 3.5 ¡À 1.3 cm<sup>2</sup>/m<sup>2 </sup>(P = 0.002) in responders, but decreased from 3.4 ¡À 1.2 cm<sup>2</sup>/m<sup>2</sup> to 3.0 ¡À 1.0 cm<sup>2</sup>/m<sup>2</sup> (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 &lt; 0.001). Early introduction of tolvaptan treatment is necessary to prevent the progression of sarcopenia.
%K Tolvaptan
%K Hepatic Ascites
%K Sarcopenia
%K Loop Diuretics
%K Long-Term Prognosis
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=85297