Cargando…
The Efficacy, the Treatment Response and the Aquaretic Effects of a Three-Year Tolvaptan Regimen in Polycystic Kidney Disease Patients
Tolvaptan, a selective vasopressin V2 receptor antagonist, is the first and only approved specific treatment for Autosomal-Dominant Polycystic Kidney Disease (ADPKD), and is used in current clinical practice. Real clinical data are missing. In this retrospective study, 41 ADPKD patients received tol...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514807/ https://www.ncbi.nlm.nih.gov/pubmed/37736928 http://dx.doi.org/10.3390/clinpract13050092 |
_version_ | 1785108805674074112 |
---|---|
author | Gkika, Vasiliki Louka, Michaela Tsagkatakis, Mihail Tsirpanlis, George |
author_facet | Gkika, Vasiliki Louka, Michaela Tsagkatakis, Mihail Tsirpanlis, George |
author_sort | Gkika, Vasiliki |
collection | PubMed |
description | Tolvaptan, a selective vasopressin V2 receptor antagonist, is the first and only approved specific treatment for Autosomal-Dominant Polycystic Kidney Disease (ADPKD), and is used in current clinical practice. Real clinical data are missing. In this retrospective study, 41 ADPKD patients received tolvaptan for 3 years, from 2018 to 2021. Total kidney volume (TKV) was measured using Magnetic Resonance Imaging, at initiation and at the end of the treatment period. A complete biochemistry/hematology profile and a 24 h urine volume collection were performed monthly for the first 18 months and every 3 months thereafter. At the end of the treatment period, the median (IQR) estimated Glomerular Filtration Rate (e-GFR) was 5.3 (−1.3, 8.7) mL/min higher than the expected e-GFR decline without treatment, while the prediction for End Stage Chronic Kidney Disease (ESKD) had been prolonged by 1 (0, 2) year. Total Kidney Volume did not change significantly (2250 (1357) mL at 3 years of treatment vs. 2180 (1091) mL expected without treatment, p = 0.48). Younger patients with a relatively preserved e-GFR, lower hypertension burden, better familiar renal prognosis and more severe imaging data showed better outcomes. The aquaretic adverse effects of tolvaptan did not affect renal function and electrolyte balance in 51 patients, in a follow-up period of 18 months. Consequently, tolvaptan seems to be effective in preventing progression of ADPKD when administered in a timely manner in patients with better familiar renal history, shorter hypertension duration and worse imaging profile. Increased diuresis does not affect treatment efficacy. |
format | Online Article Text |
id | pubmed-10514807 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-105148072023-09-23 The Efficacy, the Treatment Response and the Aquaretic Effects of a Three-Year Tolvaptan Regimen in Polycystic Kidney Disease Patients Gkika, Vasiliki Louka, Michaela Tsagkatakis, Mihail Tsirpanlis, George Clin Pract Article Tolvaptan, a selective vasopressin V2 receptor antagonist, is the first and only approved specific treatment for Autosomal-Dominant Polycystic Kidney Disease (ADPKD), and is used in current clinical practice. Real clinical data are missing. In this retrospective study, 41 ADPKD patients received tolvaptan for 3 years, from 2018 to 2021. Total kidney volume (TKV) was measured using Magnetic Resonance Imaging, at initiation and at the end of the treatment period. A complete biochemistry/hematology profile and a 24 h urine volume collection were performed monthly for the first 18 months and every 3 months thereafter. At the end of the treatment period, the median (IQR) estimated Glomerular Filtration Rate (e-GFR) was 5.3 (−1.3, 8.7) mL/min higher than the expected e-GFR decline without treatment, while the prediction for End Stage Chronic Kidney Disease (ESKD) had been prolonged by 1 (0, 2) year. Total Kidney Volume did not change significantly (2250 (1357) mL at 3 years of treatment vs. 2180 (1091) mL expected without treatment, p = 0.48). Younger patients with a relatively preserved e-GFR, lower hypertension burden, better familiar renal prognosis and more severe imaging data showed better outcomes. The aquaretic adverse effects of tolvaptan did not affect renal function and electrolyte balance in 51 patients, in a follow-up period of 18 months. Consequently, tolvaptan seems to be effective in preventing progression of ADPKD when administered in a timely manner in patients with better familiar renal history, shorter hypertension duration and worse imaging profile. Increased diuresis does not affect treatment efficacy. MDPI 2023-08-24 /pmc/articles/PMC10514807/ /pubmed/37736928 http://dx.doi.org/10.3390/clinpract13050092 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gkika, Vasiliki Louka, Michaela Tsagkatakis, Mihail Tsirpanlis, George The Efficacy, the Treatment Response and the Aquaretic Effects of a Three-Year Tolvaptan Regimen in Polycystic Kidney Disease Patients |
title | The Efficacy, the Treatment Response and the Aquaretic Effects of a Three-Year Tolvaptan Regimen in Polycystic Kidney Disease Patients |
title_full | The Efficacy, the Treatment Response and the Aquaretic Effects of a Three-Year Tolvaptan Regimen in Polycystic Kidney Disease Patients |
title_fullStr | The Efficacy, the Treatment Response and the Aquaretic Effects of a Three-Year Tolvaptan Regimen in Polycystic Kidney Disease Patients |
title_full_unstemmed | The Efficacy, the Treatment Response and the Aquaretic Effects of a Three-Year Tolvaptan Regimen in Polycystic Kidney Disease Patients |
title_short | The Efficacy, the Treatment Response and the Aquaretic Effects of a Three-Year Tolvaptan Regimen in Polycystic Kidney Disease Patients |
title_sort | efficacy, the treatment response and the aquaretic effects of a three-year tolvaptan regimen in polycystic kidney disease patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514807/ https://www.ncbi.nlm.nih.gov/pubmed/37736928 http://dx.doi.org/10.3390/clinpract13050092 |
work_keys_str_mv | AT gkikavasiliki theefficacythetreatmentresponseandtheaquareticeffectsofathreeyeartolvaptanregimeninpolycystickidneydiseasepatients AT loukamichaela theefficacythetreatmentresponseandtheaquareticeffectsofathreeyeartolvaptanregimeninpolycystickidneydiseasepatients AT tsagkatakismihail theefficacythetreatmentresponseandtheaquareticeffectsofathreeyeartolvaptanregimeninpolycystickidneydiseasepatients AT tsirpanlisgeorge theefficacythetreatmentresponseandtheaquareticeffectsofathreeyeartolvaptanregimeninpolycystickidneydiseasepatients AT gkikavasiliki efficacythetreatmentresponseandtheaquareticeffectsofathreeyeartolvaptanregimeninpolycystickidneydiseasepatients AT loukamichaela efficacythetreatmentresponseandtheaquareticeffectsofathreeyeartolvaptanregimeninpolycystickidneydiseasepatients AT tsagkatakismihail efficacythetreatmentresponseandtheaquareticeffectsofathreeyeartolvaptanregimeninpolycystickidneydiseasepatients AT tsirpanlisgeorge efficacythetreatmentresponseandtheaquareticeffectsofathreeyeartolvaptanregimeninpolycystickidneydiseasepatients |