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  1. Article ; Online: Macrophage-1 antigen exacerbates histone-induced acute lung injury and promotes neutrophil extracellular trap formation.

    Mizuno, Tomohiro / Nagano, Fumihiko / Takahashi, Kazuo / Yamada, Shigeki / Fruhashi, Kazuhiro / Maruyama, Shoichi / Tsuboi, Naotake

    FEBS open bio

    2024  Volume 14, Issue 4, Page(s) 574–583

    Abstract: Acute lung injury (ALI), which occurs in association with sepsis, trauma, and coronavirus disease 2019 (COVID-19), is a serious clinical condition with high mortality. Excessive platelet-leukocyte aggregate (PLA) formation promotes neutrophil ... ...

    Abstract Acute lung injury (ALI), which occurs in association with sepsis, trauma, and coronavirus disease 2019 (COVID-19), is a serious clinical condition with high mortality. Excessive platelet-leukocyte aggregate (PLA) formation promotes neutrophil extracellular trap (NET) release and thrombosis, which are involved in various diseases, including ALI. Macrophage-1 antigen (Mac-1, CD11b/CD18), which is expressed on the surface of leukocytes, is known to promote NET formation. This study aimed to elucidate the role of Mac-1 in extracellular histone-induced ALI. Exogenous histones were administered to Mac-1-deficient mice and wild-type (WT) mice with or without neutrophil or platelet depletion, and several parameters were investigated 1 h after histone injection. Depletion of neutrophils or platelets improved survival time and macroscopic and microscopic properties of lung tissues, and decreased platelet-leukocyte formation and plasma myeloperoxidase levels. These improvements were also observed in Mac-1
    MeSH term(s) Animals ; Mice ; Extracellular Traps/metabolism ; Macrophage-1 Antigen/metabolism ; Histones ; Neutrophils/metabolism ; Acute Lung Injury
    Chemical Substances Macrophage-1 Antigen ; Histones
    Language English
    Publishing date 2024-02-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2651702-4
    ISSN 2211-5463 ; 2211-5463
    ISSN (online) 2211-5463
    ISSN 2211-5463
    DOI 10.1002/2211-5463.13779
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Additional renoprotective effect of the SGLT2 inhibitor dapagliflozin in a patient with ADPKD receiving tolvaptan treatment.

    Minatoguchi, Shun / Hayashi, Hiroki / Umeda, Ryosuke / Koide, Shigehisa / Hasegawa, Midori / Tsuboi, Naotake

    CEN case reports

    2024  

    Abstract: Autosomal dominant polycystic kidney disease (ADPKD) is a major cause of end-stage kidney disease (ESKD). Vasopressin plays a pivotal role in ADPKD progression; therefore, the selective vasopressin V2 receptor antagonist tolvaptan is used as a key drug ... ...

    Abstract Autosomal dominant polycystic kidney disease (ADPKD) is a major cause of end-stage kidney disease (ESKD). Vasopressin plays a pivotal role in ADPKD progression; therefore, the selective vasopressin V2 receptor antagonist tolvaptan is used as a key drug in the management of ADPKD. On the other hand, sodium-glucose cotransporter-2 inhibitors (SGLT2i), which may possibly stimulate vasopressin secretion due to the diuretic effect of the drug, have been shown to have both renal and cardioprotective effects in various populations, including those with non-diabetic chronic kidney disease. However, the effect of SGLT2i in patients with ADPKD have not been fully elucidated. Herein, we report the case of a patient with ADPKD on tolvaptan who was administered the SGLT2i dapagliflozin. The patient was a Japanese woman diagnosed with ADPKD at age 30. Despite the treatment with tolvaptan, eGFR was gradually declined from 79.8 to 50 ml/min/1.73 m
    Language English
    Publishing date 2024-03-18
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 2660492-9
    ISSN 2192-4449 ; 2192-4449
    ISSN (online) 2192-4449
    ISSN 2192-4449
    DOI 10.1007/s13730-024-00859-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Assessing protein and albumin recovery rates in different ascites filtration membrane washing methods for cell-free and concentrated ascites reinfusion therapy.

    Yamada, Sachie / Nii, Norio / Ohashi, Atsushi / Hasegawa, Midori / Yuzawa, Yukio / Tsuboi, Naotake

    Fujita medical journal

    2024  Volume 10, Issue 2, Page(s) 53–59

    Abstract: Objectives: In cell-free and concentrated ascites reinfusion therapy (CART), the protein recovery rate decreases when the filtration membrane gets clogged. Employing a device with a filtration membrane washing feature prevents clogging, but it leads to ... ...

    Abstract Objectives: In cell-free and concentrated ascites reinfusion therapy (CART), the protein recovery rate decreases when the filtration membrane gets clogged. Employing a device with a filtration membrane washing feature prevents clogging, but it leads to the loss of ascites within the filter, resulting in reduced protein recovery. This study employed a device with a membrane washing function to investigate the relationship between protein recovery rate and the quantity of washing solution used, depending on the selected washing method.
    Methods: We analyzed cases of CART conducted at Fujita Health University Hospital between May 2021 and November 2022. The cases were divided and compared between two groups: one using flush and rinse as the washing method (flush+rinse group) and another using only flushing (flush group).
    Results: We identified nine cases and 16 sessions. In the flush+rinse group, the median amount of washing solution used per membrane washing was 259 mL per cycle, whereas it was 54 mL per cycle in the flush group. This difference was statistically significant (p<0.0001). The median total protein recovery rate was 53.8% for the flush+rinse group and 78.8% for the flush group, with the latter showing a significantly higher value (p=0.0199).
    Conclusions: In CART using a membrane washing function, adopting a washing method that reduces the amount of washing solution leads to an increase in the total protein recovery rate.
    Language English
    Publishing date 2024-02-15
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 3011241-2
    ISSN 2189-7255 ; 2189-7247
    ISSN (online) 2189-7255
    ISSN 2189-7247
    DOI 10.20407/fmj.2023-005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Multicentre, open-label, randomised, controlled trial to compare early intervention with calcimimetics and conventional therapy in preventing coronary artery calcification in patients with secondary hyperparathyroidism (UPCOMING): a study protocol.

    Inaguma, Daijo / Tatematsu, Yoshitaka / Okamoto, Naoki / Ogata, Soshiro / Kawai, Hideki / Watanabe, Eiichi / Yuzawa, Yukio / Hasegawa, Midori / Tsuboi, Naotake

    BMJ open

    2024  Volume 14, Issue 1, Page(s) e076962

    Abstract: Introduction: Coronary artery and heart valve calcification is a risk factor for cardiovascular death in haemodialysis patients, so calcification prevention should be started as early as possible. Treatment with concomitant calcimimetics and low-dose ... ...

    Abstract Introduction: Coronary artery and heart valve calcification is a risk factor for cardiovascular death in haemodialysis patients, so calcification prevention should be started as early as possible. Treatment with concomitant calcimimetics and low-dose vitamin D receptor activators (VDRAs) is available, but not enough evidence has been obtained on the efficacy of this regimen, particularly in patients with short dialysis duration. Therefore, this study will evaluate the efficacy and safety of early intervention with upacicalcet, a calcimimetic used to prevent coronary artery calcification in this patient population.
    Methods and analysis: This multicentre, open-label, randomised, parallel-group controlled study will compare an early intervention group, which received upacicalcet and a low-dose VDRA, with a conventional therapy group, which received a VDRA. The primary endpoint is a change in log coronary artery calcium volume score from baseline to 52 weeks. The main inclusion criteria are as follows: (1) age 18 years or older; (2) dialysis is planned or dialysis duration is less than 60 months; (3) intact parathyroid hormone (PTH) >240 pg/mL or whole PTH level>140 pg/mL; (4) serum-corrected calcium≥8.4 mg/dL and (5) Agatston score >30. The main exclusion criteria are as follows: (1) history of parathyroid intervention or fracture in the past 12 weeks; (2) history of myocardial infarction, stroke or leg amputation in the past 12 weeks; (3) history of coronary angioplasty and (4) heart failure of New York Heart Association class III or worse.
    Ethics and dissemination: The study will comply with the Declaration of Helsinki and the Japanese Clinical Trials Act. The study protocol has been approved by the Fujita Health University Certified Review Board (file no. CR22-052). Written informed consent will be obtained from all participants. Study results will be presented in academic meetings and peer-reviewed academic journals.
    Trial registration number: jRCTs041220126.
    MeSH term(s) Humans ; Adolescent ; Calcium/therapeutic use ; Coronary Vessels ; Renal Dialysis ; Hyperparathyroidism, Secondary/drug therapy ; Hyperparathyroidism, Secondary/etiology ; Hyperparathyroidism, Secondary/prevention & control ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic ; Propionates
    Chemical Substances upacicalcet (5C1222PBE2) ; Calcium (SY7Q814VUP) ; Propionates
    Language English
    Publishing date 2024-01-24
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-076962
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: COVID-19 mRNA vaccination is associated with IgA nephropathy: an analysis of the Japanese adverse drug event report database.

    Nakao, Hiroka / Koseki, Takenao / Kato, Koki / Yamada, Shigeki / Tsuboi, Naotake / Takahashi, Kazuo / Mizuno, Tomohiro

    Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques

    2023  Volume 26, Page(s) 11453

    Abstract: Purpose: ...

    Abstract Purpose:
    MeSH term(s) Humans ; SARS-CoV-2/genetics ; COVID-19/prevention & control ; Glomerulonephritis, IGA/genetics ; COVID-19 Vaccines/adverse effects ; East Asian People ; Adverse Drug Reaction Reporting Systems ; Drug-Related Side Effects and Adverse Reactions ; Vaccination/adverse effects ; mRNA Vaccines
    Chemical Substances COVID-19 Vaccines ; mRNA Vaccines
    Language English
    Publishing date 2023-06-30
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1422972-9
    ISSN 1482-1826 ; 1482-1826
    ISSN (online) 1482-1826
    ISSN 1482-1826
    DOI 10.3389/jpps.2023.11453
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Effects of N-acetyl-L-tryptophan on desorption of the protein-bound uremic toxin indoxyl sulfate and effects on uremic sarcopenia.

    Ohashi, Atsushi / Nakatani, Masashi / Hori, Hideo / Nakai, Shigeru / Tsuchida, Kunihiro / Hasegawa, Midori / Tsuboi, Naotake

    Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy

    2023  Volume 27, Issue 6, Page(s) 1023–1027

    Abstract: Introduction: Indoxyl sulfate (IS) is a protein-bound uremic toxin that causes uremic sarcopenia. IS has poor dialysis clearance; however, the addition of a binding competitor improves its removal efficiency.: Methods: Dialysis experiments were ... ...

    Abstract Introduction: Indoxyl sulfate (IS) is a protein-bound uremic toxin that causes uremic sarcopenia. IS has poor dialysis clearance; however, the addition of a binding competitor improves its removal efficiency.
    Methods: Dialysis experiments were performed using N-acetyl-l-tryptophan (L-NAT) instead of l-tryptophan (Trp) using pooled sera obtained from dialysis patients. The molecular structures of L-NAT and Trp were similar to that of IS. Therefore, we examined whether Trp and L-NAT were involved in muscle atrophy in the same manner as IS by performing culture experiments using a human myotube cell line.
    Results: The removal efficiency of L-NAT was the same as that of Trp. However, L-NAT concentrations in the pooled sera increased at the end of the experiment. Trp (1 mM) decreased the area of human myocytes, similar to IS, whereas L-NAT did not.
    Conclusion: L-NAT is a binding competitor with the ability to remove protein-bound IS while preventing sarcopenia.
    MeSH term(s) Humans ; Sarcopenia/metabolism ; Uremia/metabolism ; Indican ; Tryptophan ; Uremic Toxins
    Chemical Substances Indican (N187WK1Y1J) ; Tryptophan (8DUH1N11BX) ; Uremic Toxins
    Language English
    Publishing date 2023-08-19
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2119809-3
    ISSN 1744-9987 ; 1091-6660 ; 1744-9979
    ISSN (online) 1744-9987
    ISSN 1091-6660 ; 1744-9979
    DOI 10.1111/1744-9987.14047
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Expression of a Crry/p65 is reduced in acute lung injury induced by extracellular histones

    Nagano, Fumihiko / Mizuno, Tomohiro / Imai, Masaki / Takahashi, Kazuo / Tsuboi, Naotake / Maruyama, Shoichi / Mizuno, Masashi

    FEBS Open Bio. 2022 Jan., v. 12, no. 1

    2022  

    Abstract: Acute lung injury (ALI) occurs in patients with severe sepsis and has a mortality rate of 40%–60%. Severe sepsis promotes the release of histones from dying cells, which can induce platelet aggregation, activate coagulation and cause endothelial cell (EC) ...

    Abstract Acute lung injury (ALI) occurs in patients with severe sepsis and has a mortality rate of 40%–60%. Severe sepsis promotes the release of histones from dying cells, which can induce platelet aggregation, activate coagulation and cause endothelial cell (EC) death. We previously reported that the expression of membrane complement receptor type 1‐related gene Y (Crry)/p65, which plays a principal role in defence against abnormal activation of complement in the blood, is reduced in response to peritoneal mesothelial cell injury, and we hence hypothesized that a similar mechanism occurs in pulmonary ECs. In this study, we examined the role of Crry/p65 in histone‐mediated ALI using an experimental animal model. In ALI model mice, exposure to extracellular histones induces lung injury and results in a decrease in Crry/p65 expression. The levels of lactic acid dehydrogenase (LDH), a marker of cell damage, were significantly increased in the serum of ALI model compared with vehicle mice. The significant inverse correlation between the expression of Crry/p65 and LDH levels in plasma revealed an association between Crry/p65 expression and cell damage. The levels of complement component 3a (C3a) were also significantly increased in the serum of the ALI model compared with vehicle mice. Notably, a C3a receptor antagonist ameliorated lung injury induced by histones. We hypothesize that extracellular histones induce complement activation via down‐regulation of Crry/p65 and that C3a might serve as a therapeutic target for the treatment of ALI.
    Keywords animal models ; antagonists ; blood serum ; coagulation ; complement ; death ; endothelial cells ; genes ; histones ; laboratory animals ; lactate dehydrogenase ; lungs ; mortality ; platelet aggregation ; therapeutics
    Language English
    Dates of publication 2022-01
    Size p. 192-202.
    Publishing place John Wiley & Sons, Ltd
    Document type Article
    Note JOURNAL ARTICLE
    ZDB-ID 2651702-4
    ISSN 2211-5463
    ISSN 2211-5463
    DOI 10.1002/2211-5463.13322
    Database NAL-Catalogue (AGRICOLA)

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  8. Article: Frequency of Immune Checkpoint Inhibitor-Induced Vasculitides: An Observational Study Using Data From the Japanese Adverse Drug Event Report Database.

    Kato, Koki / Mizuno, Tomohiro / Koseki, Takenao / Ito, Yoshimasa / Takahashi, Kazuo / Tsuboi, Naotake / Yamada, Shigeki

    Frontiers in pharmacology

    2022  Volume 13, Page(s) 803706

    Abstract: Information on immune checkpoint inhibitor-induced vasculitides is limited, and predictors for this condition have not been identified. Therefore, we have examined the frequency of immune checkpoint inhibitor-induced vasculitides by analyzing the data ... ...

    Abstract Information on immune checkpoint inhibitor-induced vasculitides is limited, and predictors for this condition have not been identified. Therefore, we have examined the frequency of immune checkpoint inhibitor-induced vasculitides by analyzing the data recorded in the Japanese Adverse Drug Event Report database. Data from April 2004 to March 2020 were extracted, and vasculitides as an immune-related adverse event was defined according to the 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Adverse event signals were recognized as significant when the reporting odds ratio estimates and lower limits of the corresponding 95% confidence intervals exceeded 1. The use of nivolumab showed a significant signal for vasculitides. Furthermore, significant signals of polymyalgia rheumatica were found when the patients were treated with nivolumab, pembrolizumab, and ipilimumab. In addition, the frequencies of nivolumab- and pembrolizumab-induced polymyalgia rheumatica were higher in patients aged ≥70 years and female patients, respectively. Polymyalgia rheumatica was reported in 38 patients treated with nivolumab; 31 (82%) of these were either in recovery or in remission. Further, polymyalgia rheumatica was reported in 17 patients treated with pembrolizumab; 13 (76%) of these were in recovery or remission, while three (18%) were not. Polymyalgia rheumatica was reported in 12 patients treated with ipilimumab; seven (58%) of these were in recovery or remission. Our study highlights that careful monitoring for the symptom of PMR (e.g., bilateral pain in shoulder and pelvic girdles) is required when the patients are aged >70 years and have been treated with nivolumab and when the patients are women and have been treated with pembrolizumab.
    Language English
    Publishing date 2022-03-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2587355-6
    ISSN 1663-9812
    ISSN 1663-9812
    DOI 10.3389/fphar.2022.803706
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Efficacy of Ascorbic Acid, Thiamine, and Hydrocortisone Combination Therapy: Meta-analysis of Randomized Controlled Trials.

    Kato, Takahiro / Mizuno, Tomohiro / Nakanishi, Masanori / Lee, Jeannie K / Yamada, Shigeki / Tsuboi, Naotake / Takahashi, Kazuo

    In vivo (Athens, Greece)

    2023  Volume 37, Issue 3, Page(s) 1236–1245

    Abstract: Background/aim: Sepsis is a life-threatening biological condition that induces systemic tissue and organ dysfunction and confers a high mortality risk. Although the use of hydrocortisone in combination with ascorbic acid and thiamine (HAT therapy) ... ...

    Abstract Background/aim: Sepsis is a life-threatening biological condition that induces systemic tissue and organ dysfunction and confers a high mortality risk. Although the use of hydrocortisone in combination with ascorbic acid and thiamine (HAT therapy) significantly reduced mortality from sepsis or septic shock in a previous study, it did not improve mortality in subsequent randomized controlled trials (RCTs). Therefore, no definitive conclusion has been established on the benefits of HAT therapy for sepsis or septic shock. We performed a meta-analysis to assess the treatment outcomes of HAT therapy in patients with sepsis or septic shock.
    Patients and methods: We searched databases (PubMed/MEDLINE, Embase, Scopus and Cochrane Library) for RCTs using the terms "ascorbic acid", "thiamine", "sepsis", "septic shock", and "RCT". The primary outcome of this meta-analysis was the mortality rate, and the secondary outcomes were the incidence of new-onset acute renal injury (AKI), intensive care unit (ICU) length of stay (ICU-LOS), change in the Sequential Organ Failure Assessment (SOFA) score within 72 hours, and duration of vasopressor use.
    Results: Nine RCTs were identified and included in the outcome evaluation. HAT therapy did not improve the 28-day and ICU mortality, new-onset AKI, ICU-LOS, or SOFA scores. However, HAT therapy significantly shortened the duration of vasopressor use.
    Conclusion: HAT therapy did not improve mortality, the SOFA score, renal injury, or ICU-LOS. Further studies are needed to confirm whether it shortens the duration of vasopressor use.
    MeSH term(s) Humans ; Hydrocortisone/therapeutic use ; Thiamine/therapeutic use ; Ascorbic Acid/therapeutic use ; Randomized Controlled Trials as Topic ; Shock, Septic/drug therapy ; Sepsis ; Acute Kidney Injury
    Chemical Substances Hydrocortisone (WI4X0X7BPJ) ; Thiamine (X66NSO3N35) ; Ascorbic Acid (PQ6CK8PD0R)
    Language English
    Publishing date 2023-04-27
    Publishing country Greece
    Document type Meta-Analysis ; Journal Article
    ZDB-ID 807031-3
    ISSN 1791-7549 ; 0258-851X
    ISSN (online) 1791-7549
    ISSN 0258-851X
    DOI 10.21873/invivo.13200
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Tolvaptan's Association with Low Risk of Acute Kidney Injury in Patients with Advanced Chronic Kidney Disease and Acute Decompensated Heart Failure.

    Tagaya, Tomoki / Hayashi, Hiroki / Ogata, Soshiro / Takahashi, Kazuo / Koide, Shigehisa / Inaguma, Daijo / Hasegawa, Midori / Yuzawa, Yukio / Tsuboi, Naotake

    American journal of nephrology

    2023  Volume 54, Issue 7-8, Page(s) 319–328

    Abstract: Introduction: Furosemide, a loop diuretic, is often empirically used to treat acute decompensated heart failure (ADHF) initially. Conversely, decongestion using tolvaptan, an aquaretic, is thought to maintain renal function compared to furosemide. ... ...

    Abstract Introduction: Furosemide, a loop diuretic, is often empirically used to treat acute decompensated heart failure (ADHF) initially. Conversely, decongestion using tolvaptan, an aquaretic, is thought to maintain renal function compared to furosemide. However, it has not been investigated in patients with advanced chronic kidney disease (CKD) at high risk of developing acute kidney injury (AKI). This study aimed to investigate AKI incidence using tolvaptan add-on treatment, compared to increased furosemide treatment for patients with ADHF complicated by advanced CKD.
    Methods: We retrospectively studied patients with advanced CKD (estimated glomerular filtration rate [eGFR] <45 mL/min/1.73 m2) who developed ADHF under outpatient furosemide treatment. The exposure was set to tolvaptan add-on treatment, and the control was set to increased furosemide treatment.
    Results: Of the 163 patients enrolled, 79 were in the tolvaptan group and 84 in the furosemide group. The mean age was 71.6 years, the percentage of males was 63.8%, the mean eGFR was 15.7 mL/min/1.73 m2, and patients with CKD stage G5 were 61.9%. AKI incidence was 17.7% in the tolvaptan group and 42.9% in the furosemide group (odds ratio [95% confidence interval]: 0.34 [0.13-0.86], p = 0.023 in multivariate logistic regression analysis). Persistent AKI incidence was 11.8% in the tolvaptan group and 32.9% in the furosemide group (odds ratio [95% confidence interval]: 0.34 [0.10-1.06], p = 0.066 in the multinomial logit analysis).
    Conclusion: This study suggests that tolvaptan may be better than furosemide in patients with ADHF experiencing complicated advanced CKD.
    MeSH term(s) Male ; Humans ; Aged ; Tolvaptan/adverse effects ; Furosemide/adverse effects ; Antidiuretic Hormone Receptor Antagonists/adverse effects ; Retrospective Studies ; Benzazepines ; Heart Failure/complications ; Heart Failure/drug therapy ; Heart Failure/epidemiology ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/chemically induced ; Acute Kidney Injury/etiology ; Acute Kidney Injury/chemically induced ; Acute Disease
    Chemical Substances Tolvaptan (21G72T1950) ; Furosemide (7LXU5N7ZO5) ; Antidiuretic Hormone Receptor Antagonists ; Benzazepines
    Language English
    Publishing date 2023-06-29
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000531692
    Database MEDical Literature Analysis and Retrieval System OnLINE

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