Effect of tolvaptan in a patient with autosomal dominant polycystic kidney disease after living donor liver transplantation

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• 作者：Kiyotaka Uchiyama ; Kazuya Honda ; Ryochi Yoshida ; Yuka Kamijo…
• 关键词：Autosomal dominant polycystic kidney disease (ADPKD) ; Tolvaptan ; Liver transplantation (LT)
• 刊名：CEN Case Reports
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：5
• 期：2
• 页码：227-231
• 全文大小：
• 刊物主题：Nephrology; Urology;
• 出版者：Springer Japan
• ISSN：2192-4449
• 卷排序：5

文摘

Recently, a large randomized placebo-controlled trial indicated a beneficial effect of tolvaptan on the progression of autosomal dominant polycystic kidney disease (ADPKD) with near-normal kidney function. Meanwhile, the evidence of tolvaptan’s efficacy in ADPKD with severe renal insufficiency was limited and higher frequency of liver enzyme elevations were observed in patients taking tolvaptan. Liver transplantation (LT) is the only curative treatment for patients with severe polycystic liver disease associated with ADPKD, but considering that liver injuries should be avoided particularly in patients who underwent LT, we must be careful to start tolvaptan in post-LT ADPKD patients. We describe the case of a patient who had developed severe renal insufficiency after living donor LT, for whom tolvaptan therapy showed marked reduction of total kidney volume and maintenance of renal function without any serious adverse events. This is the first report to show the beneficial effect and safety of tolvaptan, in a post-LT ADPKD patient with severe renal insufficiency, and hopefully will help broaden the spectrum of patients who will benefit from tolvaptan.