Kidney Week

Abstract: FR-PO324

Clinical Assessment and Prediction of Efficacy of Tolvaptan in Autosomal Dominant Polycystic Kidney (ADPKD)

Session Information

• Cystic Kidney Diseases - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Genetic Diseases of the Kidney

• 801 Cystic Kidney Diseases

Authors

• Takayanagi, Kaori, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Kaori Takayanagi,

• Kogure, Yuta, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Yuta Kogure,

• Hatano, Minoru, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Minoru Hatano,

• Hara, Hiroaki, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Hiroaki Hara,

• Hirose, Kento, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Kento Hirose,

• Ogawa, Koki, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Koki Ogawa,

• Kawai, Yuichiro, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Yuichiro Kawai,

• Yamamoto, Ryo, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Ryo Yamamoto,

• Ogawa, Tomonari, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Tomonari Ogawa,

• Kanozawa, Koichi, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Koichi Kanozawa,

• Hasegawa, Hajime, Saitama Med Center, Saitama Med Univ, Kawagoe, Japan

Hajime Hasegawa,

Background

In Japan, more than 3000 patients with autosomal dominant polycystic kidney disease (ADPKD) have received Tolvaptan therapy at present, and its averaged clinical efficacy is suggested to be approximately 50%. Here, we report the clinical efficacy of Tolvaptan in our facility, and refer to the clinical features shown in the highly effective patients.

Methods

ADPKD patients with Tolvaptan therapy who have received follow up-CT scanning one year after beginning the therapy (n=23) were retrospectively analyzed.

Results

Mean age, number of male, median value of total kidney volume (TKV), median value of kidney growth rate (KGR) and mean eGFR at the start of the therapy were 45.4±14.7 years-old, 18 cases (78.8%), 1478.3 mL, 5.4%/year, and 50.9±20 mL/min, respectively. After one year Tolvaptan therapy, TKV and KGR were reduced to 1306.5 mL and -3.7%/year, and 17 of 23 cases (73.9%) showed reduced TKV (KGR<0%) by one year Tolvaptan therapy. When all cases were divided into four groups by the quartile value of KGR, and the 1st quartile group (1-QG, most effective, median KGR=-16.3%/year) was compared to 4-QG (worst effective, median KGR=8.1%/year) by the clinical parameters at the start of the therapy, mean age, mean BMI, mean systolic blood pressure, median TKV, median KGR, mean eGFR, mean serum Na and Mg, median urine osmolality were 49.6 vs 46.4 years-old, 20.0 vs 22.0, 125.0 vs 127.0 mmHg, 1514.4 vs 2511.5 mL, 6.4 vs 9.5%/year, 54.5 vs 48.5 mL/min, 139.7 vs 141.2 mmol/L, 1.87 vs 2.08 mg/dL, 247.2 vs 415.0 mOsm/kg, respectively. In comparison of two groups, significant difference was observed in urine osmolality and serum Mg.

Conclusion

In our facility, reduction of kidney volume was observed in 73.9% of cases, and 87.6% of cases showed KGR less than 5%/year, indicating that Tolvaptan therapy is significantly effective for the inhibition of cyst growth. It is also suggested that patients showing diluted urine by accelerated water intake and low serum Mg would be particularly expectable regarding the clinical efficacy of Tolvaptan.