Efficacy of tolvaptan for the patients with advanced hepatocellular carcinoma

Figure 5 If a sufficient dose of furosemide was administered to patients whose ascites mainly developed mainly because of portal hypertension, such as in aggressive hepatocellular carcinoma, it decreased serum sodium concentration and subsequently attenuated antidiuretic hormone secretion. In that condition, the effect of tolvaptan might be limited (A). In contrast, in patients with ascites that developed mainly because of attenuated liver function, hormonal diuretic systems were activated. A sufficient dose of furosemide reduced the role of the RAA system, and increased that of ADH (B). ADH: Antidiuretic hormone; RAA: Renin-angiotensin-aldosterone.