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ID 115436
Title Alternative
1-year tolvaptan efficacy in ADPKD
Author
Murakami, Taichi Ehime Prefectural Central Hospital|Tokushima University KAKEN Search Researchers
Nishimura, Kenji Tokushima University
Ono, Hiroyuki Tokushima University
Ueta, Sayo Tokushima University
Miya, Keiko Kawashima Hospital
Shima, Hisato Kawashima Hospital
Tashiro, Manabu Kawashima Hospital
Inoue, Tomoko Kawashima Hospital
Kawahara, Kazuhiko Kawashima Hospital
Minakuchi, Jun Kawashima Hospital
Keywords
autosomal dominant polycystic kidney disease
tolvaptan
theraputic efficacy
Content Type
Journal Article
Description
Autosomal dominant polycystic kidney disease (ADPKD) develops into end-stage kidney disease by 65 years of age in an estimated 45%-70% of patients. Recent trials revealed that tolvaptan inhibits disease progression both in early-stage or late-stage ADPKD ; however, stratified analysis showed a difference of favorable factors correlated with tolvaptan efficacy between early-stage and late-stage ADPKD. Thus, we examined the efficacy of tolvaptan in ADPKD with a wide range of estimated glomerular filtration rates (eGFR). We enrolled 24 patients with eGFR 35.3 (28.0-65.5) ml / min / 1.73m2 and evaluated treatment effect as ΔΔeGFR (ml / min / 1.73m2 / year) or ΔΔtotal kidney volume (TKV) (% / year) that was calculated as post-treatment annual change - pre-treatment annual change. Pre ΔeGFR was significantly low in eGFR responders, defined as ΔΔeGFR > 0 ml / min / 1.73m2 / year. In eGFR responders, pre ΔeGFR, post ΔeGFR, eGFR, TKV, and proteinuria were significantly correlated with ΔΔeGFR. In TKV responders defined as ΔΔTKV > 5 % / year, we identified hypertension history, proteinuria, TKV, and post ΔTKV as significantly correlated factors with ΔΔTKV. In conclusion, pre ΔeGFR may be a predictive factor of therapeutic efficacy on kidney function. Tolvaptan may have greater efficacy in early-stage ADPKD with rapid GFR decline or with well-controlled blood pressure.
Journal Title
The Journal of Medical Investigation
ISSN
13496867
13431420
NCID
AA11166929
Publisher
Tokushima University Faculty of Medicine
Volume
67
Issue
3-4
Start Page
315
End Page
320
Sort Key
315
Published Date
2020-08
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
Medical Sciences
University Hospital