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Two autosomal dominant polycystic kidney (ADPKD) cases with advanced renal dysfunction, effectively treated with tolvaptan

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Abstract

We report here two cases of autosomal dominant polycystic kidney disease (ADPKD) with renal dysfunction that were treated with tolvaptan. Case 1 was a 47-year-old man with a glomerular filtration rate (GFR) of 17.0 ml/min/1.73 m2 who received tolvaptan treatment (30 mg/day). After treatment, kidney pain was alleviated, and the estimated GFR (eGFR) decline improved from −9.84 ml/min/1.73 m2 per year to −4.08 ml/min/1.73 m2 per year, respectively. The rate of increase in total kidney volume was reduced from 18 % per year before treatment to 4 % per year following tolvaptan administration. Case 2 was a 44-year-old man with a GFR of 22.6 ml/min/1.73 m2, and the eGFR decline improved from −5.76 ml/min/1.73 m2 per year before treatment to −3.12 ml/min/1.73 m2 per year following tolvaptan treatment (30 mg/day). The rate of increase in total kidney volume was also decreased from 10 % per year before treatment to −7 % per year following tolvaptan administration. These results suggested that tolvaptan may be effective in impeding kidney function aggravation and kidney volume increase in ADPKD patients with advanced renal dysfunction.

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References

  1. Grantham JJ, Cook LT, Torres VE, Bost JE, Chapman AB, et al. Determinants of renal volume in autosomal-dominant polycystic kidney disease. Kidney Int. 2008;73:108–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet. 2007;369:1287–301.

    Article  PubMed  Google Scholar 

  3. Yamamura Y, Nakamura S, Itoh S, Hirano T, Onogawa T, et al. OPC-41061, a highly potent human vasopressin V2-receptor antagonist: pharmacological profile and aquaretic effect by single and multiple oral dosing in rats. J Pharmacol Exp Ther. 1998;287:860–7.

    CAS  PubMed  Google Scholar 

  4. Hirano T, Yamamura Y, Nakamura S, Onogawa T, Mori T. Effects of the V(2)-receptor antagonist OPC-41061 and the loop diuretic furosemide alone and in combination in rats. J Pharmacol Exp Ther. 2000;292:288–94.

    CAS  PubMed  Google Scholar 

  5. Grantham JJ, Chapman AB, Torres VE. Volume progression in autosomal dominant polycystic kidney disease: the major factor determining clinical outcomes. Clin J Am Soc Nephrol. 2006;1:148–57.

    Article  PubMed  Google Scholar 

  6. Higashihara E, Nutahara K, Okegawa T, Shishido T, Tanbo M, et al. Kidney volume and function in autosomal dominant polycystic kidney disease. Clin Exp Nephrol. 2014;18:157–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Torres VE, Chapman AB, Devuyst O, Gansevoort RT, Grantham JJ, et al. Tolvaptan in patients with autosomal dominant polycystic kidney disease. N Engl J Med. 2012;367:2407–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kelsey R. Polycystic kidney disease: tolvaptan in ADPKD-TEMPO 3:4 trial results. Nat Rev Nephrol. 2013;9:1.

    Article  PubMed  Google Scholar 

  9. Muto S, Kawano H, Higashihara E, Narita I, Ubara Y, et al. The effect of tolvaptan on autosomal dominant polycystic kidney disease patients: a subgroup analysis of the Japanese patient subset from TEMPO 3:4 trial. Clin Exp Nephrol. 2015;19:867–77.

    Article  CAS  PubMed  Google Scholar 

  10. Torres VE, Gansevoort RT, Czerwiec FS. Tolvaptan in autosomal dominant polycystic kidney disease. N Engl J Med. 2013;368:1259.

    CAS  PubMed  Google Scholar 

  11. Aihara M, Fujiki H, Mizuguchi H, Hattori K, Ohmoto K, et al. Tolvaptan delays the onset of end-stage renal disease in a polycystic kidney disease model by suppressing increases in kidney volume and renal injury. J Pharmacol Exp Ther. 2014;349:258–67.

    Article  PubMed  Google Scholar 

  12. Grantham JJ. Renal pain in polycystic kidney disease: when the hurt won’t stop. J Am Soc Nephrol. 1992;2:1161–2.

    CAS  PubMed  Google Scholar 

  13. Grantham JJ, Torres VE, Chapman AB, Guay-Woodford LM, Bae KT, et al. Volume progression in polycystic kidney disease. N Engl J Med. 2006;354:2122–30.

    Article  CAS  PubMed  Google Scholar 

  14. Harris PC, Rossetti S. Determinants of renal disease variability in ADPKD. Adv Chronic Kidney Dis. 2010;17:131–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Gabow PA, Johnson AM, Kaehny WD, Kimberling WJ, Lezotte DC, et al. Factors affecting the progression of renal disease in autosomal-dominant polycystic kidney disease. Kidney Int. 1992;41:1311–9.

    Article  CAS  PubMed  Google Scholar 

  16. Johnson AM, Gabow PA. Identification of patients with autosomal dominant polycystic kidney disease at highest risk for end-stage renal disease. J Am Soc Nephrol. 1997;8:1560–7.

    CAS  PubMed  Google Scholar 

  17. Fick-Brosnahan GM, Belz MM, McFann KK, Johnson AM, Schrier RW. Relationship between renal volume growth and renal function in autosomal dominant polycystic kidney disease: a longitudinal study. Am J Kidney Dis. 2002;39:1127–34.

    Article  PubMed  Google Scholar 

  18. Schrier RW, Abebe KZ, Perrone RD, Torres VE, Braun WE, et al. Blood pressure in early autosomal dominant polycystic kidney disease. N Engl J Med. 2014;371:2255–66.

    Article  PubMed  PubMed Central  Google Scholar 

  19. King BF, Torres VE, Brummer ME, Chapman AB, Bae KT, et al. Magnetic resonance measurements of renal blood flow as a marker of disease severity in autosomal-dominant polycystic kidney disease. Kidney Int. 2003;64:2214–21.

    Article  PubMed  Google Scholar 

  20. Erickson KF, Chertow GM, Goldhaber-Fiebert JD. Cost-effectiveness of tolvaptan in autosomal dominant polycystic kidney disease. Ann Intern Med. 2013;159:382–9.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This case report was supported in part by a Grant-in-Aid for Research on Advanced Chronic Kidney Disease (REACH-J), Practical Research Project for Renal Diseases from Japan Agency for Medical Research and development, AMED.

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Correspondence to Hirayasu Kai.

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Kai, H., Shinozaki, Y., Nishikubo, A. et al. Two autosomal dominant polycystic kidney (ADPKD) cases with advanced renal dysfunction, effectively treated with tolvaptan. CEN Case Rep 5, 87–90 (2016). https://doi.org/10.1007/s13730-015-0198-6

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  • DOI: https://doi.org/10.1007/s13730-015-0198-6

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