We investigated the predictive factors for the response of tolvaptan in liver cirrhosis patients with refractory ascites. Thirty-four cirrhosis patients with refractory ascites were enrolled. All patients received oral tolvaptan in addition to conventional diuretics. Twenty-three (67.6%) patients were responders (a patient with a ≥2-kg of body weight loss after 1 week administration of tolvaptan). Blood urea nitrogen (BUN) and prevalence of severe esophageal varices (SEV) were higher in non-responders than those in responders (P=0.011 and P=0.004). In multivariate analysis, BUN >20 mg/dl (P=0.040) and the presence of SEV (P=0.019) were independent predictive factors for the response of tolvaptan. The combination of these parameters may be useful for the response of tolvaptan (AUROC 0.856).
