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Abstract: TH-PO410

The Analysis of Long-Term Course of Tolvaptan Treatment and the Study Using Kidney and Liver Derived Cyclic AMP in Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Genetic Diseases of the Kidneys

  • 1101 Genetic Diseases of the Kidneys: Cystic

Authors

  • Nakatani, Yoshihisa, Kinki Daigaku Igakubu Daigakuin Igaku Kenkyuka, Osakasayama, Osaka, Japan
  • Nakano, Yukihito, Kinki Daigaku Igakubu Daigakuin Igaku Kenkyuka, Osakasayama, Osaka, Japan
  • Arima, Shuji, Kinki Daigaku Igakubu Daigakuin Igaku Kenkyuka, Osakasayama, Osaka, Japan
Background

cAMP (Cyclic AMP) in the kidney and liver of ADPKD(Autosomal dominant polycystic kidney disease)persons cannot be measured directly. We will calculate the cAMP secreted from the kidney and liver and examine the increase of their volumes and renal prognosis.

Methods

Sixty ADPKD persons who have visited Kindai University hospital from January 2016 to January 2022. ADPKD was diagnosed, and twenty-five of them were introduced to TVP by hospitalization. After diagnosis, eGFR, plasma / urine cAMP and kidney volume were measured over time and examined. Renal and hepatic Plasma and urine cAMP was calculated.

Results

Renal cAMP was correlated with kidney volume at eGFR 30 or higher, but hepatic cAMP did not correlate with liver volume. However, abnormally high liver cAMP was observed in patients who had no longer infected with giant hepatic cyst, which was correlated with the size of the cyst. Renal cAMP was not significantly correlated with ΔeGFR, but the higher the renal cAMP, the higher the rate of renal volume increase. Before and after oral administration of TVP, renal cAMP decreased significantly from 18.0 ± 8.0 to 10.4 ± 3.4, but hepatic cAMP showed almost no change. TKV changed to the rate of +9.27% (before administration), -3.96% (1 year later), -0.80% (2 years later), and + 4.24% (3 years later) by TVP administration. And the ΔeGFR is -6.7 ml / min (before administration) → 1 year later -3.6 ml / min (1 year later), -3.0 ml / min (2 years later) → -3.5 ml / min (3 years later).So, we could suppress enlargement on kidney volume and the decline in renal function. Although renal cAMP dramatically decreased in an abbreviated time in patients who began to take TVP, there were any cases in which renal cAMP increased again during treatment if the amount of TVP taken was not sufficient.

Conclusion

Renal cAMP can be a marker for the predict of ADPKD renal volume development and the increase of TVP dose. However, it was found that hepatic cAMP was not a marker for liver volume development and was not affected by TVP.