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武田 志帆
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Non peer reviewed |
| Title | Immediate drop of urine osmolality upon tolvaptan initiation predicts impact on renal prognosis in patients with ADPKD. |
| Journal | Formal name：Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Abbreviation：Nephrol Dial Transplant ISSN code：14602385/09310509 |
| Volume, Issue, Page | pp.online |
| Author and coauthor | 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 |
| Publication date | 2023/11/03 |
| Summary | BACKGROUND AND HYPOTHESIS: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 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 |