Renal dysfunction is a common comorbidity in acute heart failure (AHF), and the worsening renal function (WRF) is associated with the prognosis of AHF. Although diuretics often cause WRF, tolvaptan for AHF with renal dysfunction has showed a neutral effect on prognosis of AHF. However, no one knows how to predict the improvement of renal function by tolvaptan in the treatment for AHF. We hypothesized that assessment for hemodynamics and renal function could predict the benefit of tolvaptan for renal function. We assessed 16 AHF patients treated with tolvaptan admitted to out hospital in 2015. We calculated [Pulse pressure (PP) × heart rate (HR) × serum creatinine level (sCr)] at admission as the present novel “scoring system with hemodynamics and renal function”. In the patients with sCr < 2.0 mg/dl, the changes of estimated glomerular filtration rate (eGFR) between at admission and discharge were closely linear negative relationship to [PP × HR × sCr](R2 = 0.47, P < .05). ROC curve analysis for the improvement of eGFR showed the cut-off value of [PP × HR × sCr] was 5914 value. These results suggest that the present novel scoring system [PP × HR × sCr] could strongly predict the improvement of eGFR in the patients with AHF.
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