[Slowing progression of chronic kidney disease in polycistic kidney disease patients with tolvaptan: from guidelines to clinical practice].

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and accounts for∼10% of patients on renal replacement therapy. In the last decade, no specific treatment was available and only preventive measures could be put in place to delay the onset of ESRD. Following the results of the TEMPO 3:4 study, tolvaptan was approved in many countries, for the purpose of slowing the progression of renal insufficiency. In Italy tolvaptan is available since 2016 for patients with chronic kidney disease (CKD) stage 1-3, and since 2020 for patients with CKD stage 4, who fulfil the criteria of "rapid disease progression", according to the European recommendations. After this approval, Italian nephrology units have had to change their organization to be able to identify the patients eligible for the drug and to guarantee frequent patient monitoring. In this paper, we present our three-year experiences with tolvaptan, focusing on its safety profile and tolerability, but also on the high burden of care that such therapy represents not only for doctors, but also for patients. Strategies to implement remote monitoring may be useful to reduce the burden of assistance on one side, and the medicalization of ADPKD patients in the early stage of the disease, on the other.

• Authors: Anna Giuliani, Davide Marturano, Valentina Corradi, Carlotta Caprara, Matteo Rigato, Matteo Marcello, Fiorella Gastaldon, Claudio Ronco, Monica Zanella
• Journal: Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia (G Ital Nefrol) Vol. 38 Issue 5 (Oct 26 2021) ISSN: 1724-5990 [Electronic] Italy
• PMID: 34713645 (Publication Type: Journal Article)
• Copyright: Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

Chemical References

• Antidiuretic Hormone Receptor Antagonists
• Tolvaptan

Topics

• Antidiuretic Hormone Receptor Antagonists (therapeutic use)
• Disease Progression
• Humans
• Polycystic Kidney, Autosomal Dominant (complications, drug therapy)
• Renal Insufficiency, Chronic (complications, drug therapy)
• Tolvaptan (therapeutic use)