How effective is tolvaptan for PKD?
Tolvaptan slowed a loss of renal function bŷ25% compared to placebo, with a reduction in the rate of deterioration of 1.20 mg/mL/year (95% CI: 0.62–1.78; p<0.001).
How long can you be on tolvaptan?
[04-30-2013] The U.S. Food and Drug Administration (FDA) has determined that the drug Samsca (tolvaptan) should not be used for longer than 30 days and should not be used in patients with underlying liver disease because it can cause liver injury, potentially requiring liver transplant or death.
Does tolvaptan lower GFR?
The TEMPO 3:4 trial and post hoc analysis of the TEMPO 3:4 trial showed that tolvaptan reduced the annual eGFR decline in ADPKD by 26% (from 3.70 to 2.72 mL/min/1.73 m2) [3]. Tolvaptan induced an acute decrease in eGFR during initiation of treatment.
Does tolvaptan shrink cysts?
The present case indicated that tolvaptan reduced liver as well as kidney volume in ADPKD, presumably by shrinking cysts.
How quickly does tolvaptan work?
The onset of effect is two to four hours after a dose is taken, and peak effects occur four to eight hours after administration. Taking tolvaptan with food does not appear to affect the drug’s bioavailability or its onset or duration of effect.
Does tolvaptan reduce kidney size?
The TEMPO 3:4 trial was performed as a randomized double-blind placebo-controlled parallel-group investigation, and results obtained over a 3-year period demonstrated that administration of tolvaptan reduced the annual rate of increase in total kidney volume (TKV) and lowered that of kidney function decline [6].
How much water should I drink on tolvaptan?
Because of the way it works, Tolvaptan causes thirst, increased drinking, increased urine volume and frequency and the need to pass urine at night. Typically patients will pass 5-6 litres of urine per day. Therefore you will need to drink 5-6 litres of water or non-caffeinated drinks per day.
When should you start tolvaptan?
Recommendation 1.1: We suggest that tolvaptan can be prescribed to adult ADPKD patients aged <50 years with CKD stages 1–3a (eGFR >45 mL/min/1.73 m²) who have demonstrated or who are likely to have rapidly progressing disease, but that CKD stage must be interpreted in conjunction with age.
How do you slow down PKD progression?
Drinking water and fluids throughout the day may help slow the growth of kidney cysts, which in turn could slow down a decline in kidney function. Following a low-salt diet and eating less protein might allow kidney cysts to respond better to the increase in fluids. Pain.
How much does tolvaptan increase sodium?
Tolvaptan showed significant decreases in mean body weight (regardless of dose) in comparison to placebo. Serum sodium increased by approximately 3 meq/L for tolvaptan-treated patients and decreased by −0.2 meq/L in the placebo group.
Can you drink alcohol on tolvaptan?
Avoid alcoholic drinks. Grapefruit may interact with tolvaptan and lead to unwanted side effects. Avoid the use of grapefruit products.
What slows progression of polycystic kidney disease?
PKD-affected kidney cells divide and multiply inappropriately, and form fluid-filled sacs called cysts….High Water Intake to Slow Progression of Polycystic Kidney Disease.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Kidney, Polycystic, Autosomal Dominant | Other: Water | Not Applicable |
How effective is tolvaptan for the treatment of ADPKD?
In conclusion, tolvaptan, when given over a period of 3 years, slows the increase in total kidney volume and the decline in kidney function in patients with ADPKD. The potential benefit is not without risks. Thirst, polyuria, and related adverse events may affect the ability of some patients to take effective doses of tolvaptan.
Is tolvaptan safe in patients with advanced liver disease?
Despite the more advanced stage of disease in the patients involved in the present trial, the safety profile of tolvaptan did not differ from that observed in the TEMPO 3:4 trial. In these two trials, elevations in the liver-enzyme levels occurred between 60 days and 240 days after the initiation of tolvaptan and became less frequent thereafter.
Is tolvaptan better for kidney disease than placebo?
The composite end point favored tolvaptan over placebo (44 vs. 50 events per 100 follow-up-years, P=0.01), with lower rates of worsening kidney function (2 vs. 5 events per 100 person-years of follow-up, P<0.001) and kidney pain (5 vs. 7 events per 100 person-years of follow-up, P=0.007).
Does tolvaptan reduce EGFR decline in patients with later stage kidney disease?
Together, these findings reveal that tolvaptan has comparable efficacy in reducing eGFR decline in subjects with later stage kidney disease as in subjects with higher eGFR, regardless of REPRISE exposure to tolvaptan or placebo. Safety and Tolerability Safety data were from the entire 3-year treatment period of the OLE trial.