ホシノ ジユンイチ
HOSHINO Junichi
星野 純一 所属 医学部 医学科(東京女子医科大学病院) 職種 教授・基幹分野長 |
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論文種別 | 総説 |
言語種別 | 英語 |
査読の有無 | 査読なし |
表題 | Immediate drop of urine osmolality upon tolvaptan initiation predicts impact on renal prognosis in patients with ADPKD |
掲載誌名 | 正式名:Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 略 称:Nephrol Dial Transplant ISSNコード:14602385/09310509 |
掲載区分 | 国外 |
巻・号・頁 | 39(6),pp.1008-1015 |
著者・共著者 | Akihisa Taro, Kataoka Hiroshi, Makabe Shiho, Manabe Shun, Yoshida Rie, Ushio Yusuke, Sato Masayo, Yajima Aiji, Hanafusa Norio, Tsuchiya Ken, Nitta Kosaku, Hoshino Junichi, Mochizuki Toshio |
担当区分 | 最終著者 |
発行年月 | 2024/05/31 |
概要 | BACKGROUND:Tolvaptan, a vasopressin V2 receptor antagonist, is used for treating autosomal dominant polycystic kidney disease (ADPKD). We focused on changes in urinary osmolality (U-Osm) after tolvaptan initiation to determine whether they were associated with the therapeutic response to tolvaptan.METHODS:This was a single-centre, prospective, observational cohort study. Seventy-two patients with ADPKD who received tolvaptan were recruited. We analysed the relationship between changes in U-Osm and annual estimated glomerular filtration rate (eGFR) in terms of renal prognostic value using univariable and multivariable linear regression analyses.RESULTS:The mean value of U-Osm immediately before tolvaptan initiation was 351.8 ± 142.2 mOsm/kg H2O, which decreased to 97.6 ± 23.8 mOsm/kg H2O in the evening. The decrease in U-Osm was maintained in the outpatient clinic 1 month later. However, the 1-month values of U-Osm showed higher variability (160.2 ± 83.8 mOsm/kg H2O) than did those in the first evening of tolvaptan administration. Multivariate analysis revealed that the baseline eGFR, baseline urinary protein and U-Osm change in the evening of the day of admission (initial U-Osm drop) were significantly correlated with the subsequent annual change in eGFR.CONCLUSIONS:U-Osm can be measured easily and rapidly, and U-Osm change within a short time after tolvaptan initiation may be a useful index for the renal prognosis in actual clinical practice. |
DOI | 10.1093/ndt/gfad232 |
PMID | 37935473 |