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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