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Long-Term Effects of Tolvaptan in Autosomal Dominant Polycystic Kidney Disease: Predictors of Treatment Response and Safety over 6 Years of Continuous Therapy.
Yamazaki, Mai; Kawano, Haruna; Miyoshi, Miho; Kimura, Tomoki; Takahashi, Keiji; Muto, Satoru; Horie, Shigeo.
Afiliación
  • Yamazaki M; Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan.
  • Kawano H; Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan.
  • Miyoshi M; Department of Advanced Informatics for Genetic Diseases, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan.
  • Kimura T; Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan.
  • Takahashi K; Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan.
  • Muto S; Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan.
  • Horie S; Department of Advanced Informatics for Genetic Diseases, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, Japan.
Int J Mol Sci ; 25(4)2024 Feb 08.
Article en En | MEDLINE | ID: mdl-38396765
ABSTRACT
Tolvaptan, an oral vasopressin V2 receptor antagonist, reduces renal volume expansion and loss of renal function in patients with autosomal dominant polycystic kidney disease (ADPKD). Data for predictive factors indicating patients more likely to benefit from long-term tolvaptan are lacking. Data were retrospectively collected from 55 patients on tolvaptan for 6 years. Changes in renal function, progression of renal dysfunction (estimated glomerular filtration rate [eGFR], 1-year change in eGFR [ΔeGFR/year]), and renal volume (total kidney volume [TKV], percentage 1-year change in TKV [ΔTKV%/year]) were evaluated at 3-years pre-tolvaptan, at baseline, and at 6 years. In 76.4% of patients, ΔeGFR/year improved at 6 years. The average 6-year ΔeGFR/year (range) minus baseline ΔeGFR/year 3.024 (-8.77-20.58 mL/min/1.73 m2). The increase in TKV was reduced for the first 3 years. A higher BMI was associated with less of an improvement in ΔeGFR (p = 0.027), and family history was associated with more of an improvement in ΔeGFR (p = 0.044). Hypernatremia was generally mild; 3 patients had moderate-to-severe hyponatremia due to prolonged, excessive water intake in response to water diuresis-a side effect of tolvaptan. Family history of ADPKD and baseline BMI were contributing factors for ΔeGFR/year improvement on tolvaptan. Hyponatremia should be monitored with long-term tolvaptan administration.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Riñón Poliquístico Autosómico Dominante / Hiponatremia Límite: Humans Idioma: En Revista: Int J Mol Sci Año: 2024 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Riñón Poliquístico Autosómico Dominante / Hiponatremia Límite: Humans Idioma: En Revista: Int J Mol Sci Año: 2024 Tipo del documento: Article País de afiliación: Japón