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ID 115436
タイトル別表記
1-year tolvaptan efficacy in ADPKD
著者
村上, 太一 Ehime Prefectural Central Hospital|Tokushima University KAKEN研究者をさがす
西村, 賢二 Tokushima University
小野, 広幸 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
キーワード
autosomal dominant polycystic kidney disease
tolvaptan
theraputic efficacy
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
The Journal of Medical Investigation
ISSN
13496867
13431420
cat書誌ID
AA11166929
出版者
Tokushima University Faculty of Medicine
67
3-4
開始ページ
315
終了ページ
320
並び順
315
発行日
2020-08
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
医学系
病院