Does tolvaptan work in PKD?

On April 24, 2018, the U.S. Food and Drug Administration (FDA) granted approval of tolvaptan to be the first treatment in the United States for adult patients with autosomal dominant polycystic kidney disease (ADPKD), the most common form of polycystic kidney disease (PKD).

What is a V2 receptor antagonist?

Vasopressin V2 receptor antagonists are a class of agents with the potential to increase free-water excretion, improve diuresis, and decrease the need for paracentesis. However, no such agent has received US Food and Drug Administration (FDA) approval for this indication.

Why are ACE inhibitors used for PKD?

Conclusion: As in other causes of non-diabetic kidney disease, antihypertensive regimens with ACE inhibitors are more effective in lowering urine protein excretion in patients with advanced PKD compared to regimens without ACE inhibitors, and this benefit is greater in patients with higher levels of baseline urine …

Does tolvaptan shrink cysts?

The present case indicated that tolvaptan reduced liver as well as kidney volume in ADPKD, presumably by shrinking cysts.

What is the function of tolvaptan?

Tolvaptan (Samsca) is used to treat hyponatremia (low levels of sodium in the blood) in people who have heart failure (condition in which the heart cannot pump enough blood to all parts of the body), syndrome of inappropriate antidiuretic hormone (SIADH; condition in which the body produces too much of a certain …

What are the side effects of tolvaptan?

Side Effects

Blurred vision.
flushed, dry skin.
frequent urination.
fruit-like breath odor.
increased hunger.
increased thirst.
increased urination.
increased volume of pale, dilute urine.

What do V2 receptors do?

The V2 receptor is predominantly expressed on the basolateral membrane of the distal convoluted tubule and collecting ducts of the kidney. Binding of AVP to renal V2 receptors stimulates the recruitment of selective water channels (aquaporins), which allow reabsorption of renal tubular water and concentration of urine.

Which drug is a selective vasopressin V2 receptor agonist?

Tolvaptan (Samsca) is an oral V2 receptor antagonist and has been approved by the US Food and Drug Administration (FDA) for use in patients with CHF or cirrhosis and hyponatremia, and is also used in patients with SIADH. Conivaptan (Vaprisol) is also approved by the US FDA for treatment of euvolemic hyponatremia.

How does blood pressure medication help with PKD?

These medicines work by reducing the amount or action of a hormone in your body called angiotensin II. This hormone can increase blood pressure. By reducing angiotensin II signalling, ACE inhibitors and ARBs reduce your blood pressure.

Does tolvaptan lower blood pressure?

Tolvaptan showed neither a significant reduction in the blood pressure nor the heart rate over the period of 5 days (p > 0.05). Patients in the placebo arm showed a significant drop in both systolic and diastolic BP at the end of 5 days (p < 0.01) without any change in heart rate (p = 0.07).

How is tolvaptan used in the treatment of ADPKD?

Tolvaptan (Jinarc(®)) is a highly selective vasopressin V2 receptor antagonist indicated for use in patients with autosomal dominant polycystic kidney disease (ADPKD). Tolvaptan is the first pharmaceutical agent to be approved in Europe for delaying the progression of ADPKD in adults with stage 1-3 chronic kidney disease at initiation of treatment.

Is there an effect of tolvaptan on CKD stage 3?

This post hoc analysis suggests clinically similar beneficial effects of tolvaptan in ADPKD across CKD stages 1-3. Effect of Tolvaptan in Autosomal Dominant Polycystic Kidney Disease by CKD Stage: Results from the TEMPO 3:4 Trial

What was the effect of tolvaptan on renal function?

Tolvaptan was also associated with a significantly lower rate of events for the composite secondary endpoint of time to investigator-assessed clinical progression relative to placebo, an effect that was largely attributable to reductions in the risk of worsening renal function and the risk of worsening kidney pain.

Which is the best Vasopressin ANtagonist for ADPKD?