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ニッタ コウサク
NITTA Kousaku
新田 孝作 所属 医学部 医学科（東京女子医科大学病院） 職種 客員教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Early changes in the urine-to-serum uric acid ratio are associated with subsequent eGFR slope during tolvaptan therapy in ADPKD. |
| 掲載誌名 | 正式名：Clinical and experimental nephrology 略 称：Clin Exp Nephrol ISSNコード：14377799/13421751 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.online |
| 著者・共著者 | Makabe Shiho, Kataoka Hiroshi, Ushio Yusuke, Manabe Shun, Otsubo Shigeru, Hanafusa Norio, Tsuchiya Ken, Nitta Kosaku, Hoshino Junichi, Mochizuki Toshio |
| 発行年月 | 2026/11/02 |
| 概要 | BACKGROUND:Tolvaptan is used to treat autosomal dominant polycystic kidney disease (ADPKD) through vasopressin V2 receptor blockade. We investigated whether the urine-to-serum (U/S) uric acid (UA) ratio, a simple, clinically accessible index, reflects early physiological changes after tolvaptan initiation and is associated with subsequent changes in renal function.METHODS:This single-center prospective observational study included 72 patients with ADPKD who initiated tolvaptan. Multivariable regression analyses evaluated factors associated with the initial change in the U/S UA ratio and its association with subsequent annual changes in estimated glomerular filtration rate (eGFR).RESULTS:The mean observation period was 2.6 ± 1.4 years. At 1 month, serum UA increased from 6.0 ± 1.4 to 6.3 ± 1.5 mg/dL, whereas the U/S UA ratio decreased from 4.3 ± 3.1 to 1.8 ± 1.2 (both P < 0.0001). Fractional excretion of UA did not change significantly, whereas urine osmolality decreased markedly. A larger initial decrease in the U/S UA ratio was associated with a slower subsequent annual eGFR decline. However, this association was attenuated and was no longer statistically significant after adjustment for the initial change in urine osmolality. In sex-stratified analyses, the association was significant in women but not in men, although the sex-by-U/S UA ratio change interaction was not significant (P = 0.883).CONCLUSIONS:The U/S UA ratio is a simple, clinically accessible index reflecting early physiological changes after tolvaptan initiation. Its association with subsequent eGFR decline appears partly influenced by changes in urine osmolality and requires prospective validation. |
| DOI | 10.1007/s10157-026-02955-1 |
| PMID | 42970194 |