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https://www.readbyqxmd.com/read/29145907/-autosomal-dominant-polycystic-kidney-disease-should-patients-young-adult-relatives-be-screened-or-not
#1
B J Kramers, M Storm, R T Gansevoort
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disease, with a global prevalence of 10 per 10,000. It is characterized by the formation of numerous cysts in both kidneys, and leads to renal function loss; the majority of patients will eventually need renal replacement therapy. It is possible to screen patients' presymptomatic family members from a young age, but this has not historically been recommended as until recently there were no treatment options. This year, the vasopressin V2 receptor antagonist tolvaptan was approved for prescription in ADPKD, to slow the rate of renal function decline...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29130954/effects-of-tolvaptan-addition-to-furosemide-in-normo-and-hyponatremia-patients-with-heart-failure-and-chronic-kidney-disease-stages-g3b-5-a-subanalysis-of-the-k-star-study
#2
Naoto Tominaga, Keisuke Kida, Takayuki Inomata, Naoki Sato, Tohru Izumi, Yoshihiro J Akashi, Yugo Shibagaki
BACKGROUND: Tolvaptan increases free water clearance (aquaresis) and thereby improves hyponatremia. Although hyponatremia on admission is common in patients with congestive heart failure (CHF), little is known regarding the response to tolvaptan in those who also have chronic kidney disease (CKD) with or without hyponatremia. The aim of this subanalysis was to investigate the differences in treatment response between normo- and hyponatremia patients with CHF and CKD stages G3b-5. METHODS: The Kanagawa Aquaresis Investigators Trial of Tolvaptan on HF Patients with Renal Impairment (K-STAR) was a multicenter, open-label, randomized, controlled prospective clinical trial that included 81 Japanese patients with CHF and residual signs of congestion despite oral furosemide treatment (≥40 mg/day)...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29128962/good-response-to-tolvaptan-shortens-hospitalization-in-patients-with-congestive-heart-failure
#3
Tomohito Kogure, Kentaro Jujo, Kazuyuki Hamada, Katsumi Saito, Nobuhisa Hagiwara
Tolvaptan has been gradually spread to use as a potent diuretic for congestive heart failure in the limited country. However, the response to this aquaretic drug still is unpredictable. A total of 92 patients urgently hospitalized due to congestive heart failure and treated with tolvaptan in addition to standard treatment was retrospectively analyzed. Responder of tolvaptan treatment was defined as a patient with peak negative fluid balance greater than 500 mL/day, and clinical profiles were compared between 76 responders and 16 non-responders...
November 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29128961/the-relationship-between-the-time-until-commencement-of-tolvaptan-and-the-length-of-hospital-stay-in-heart-failure-patients
#4
Shunsuke Kiuchi, Shinji Hisatake, Takayuki Kabuki, Takashi Oka, Shintaro Dobashi, Takahiro Fujii, Takanori Ikeda
The effect of early use of tolvaptan (TLV) for acute decompensated heart failure (ADHF) is unclear. We investigated the relationship between early use of TLV and the length of hospital stay. 369 consecutive ADHF patients who received TLV during hospitalization between February 2011 and June 2016 were initially enrolled. Patients who died in hospital, transferred hospital or clinical scenario 4 or 5 were excluded. We analyzed 247 ADHF patients. We evaluated the relationship between the length of hospital stay and the following findings: blood pressures, heart rate, New York Heart Association classification, and blood tests on admission...
November 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29123425/long-term-safety-profile-of-tolvaptan-in-autosomal-dominant-polycystic-kidney-disease-patients-tempo-extension-japan-trial
#5
Satoru Muto, Tadashi Okada, Moriyoshi Yasuda, Hidetsugu Tsubouchi, Koji Nakajima, Shigeo Horie
Aim: The aim of this trial (ClinicalTrials.gov identifier: NCT01280721) was to investigate the long-term safety profile of tolvaptan in Japanese patients with autosomal dominant polycystic kidney disease (ADPKD). Methods: This open-label multicenter trial was conducted to examine adverse drug reactions (ADRs) related to tolvaptan up to an additional 3 years in 135 Japanese patients who participated in the Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and its Outcomes (TEMPO) 3:4 trial at doses of 60-120 mg/d...
2017: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29110656/in-patient-tolvaptan-use-in-siadh-care-audit-therapy-observation-and-outcome-analysis
#6
Malik Asif Humayun, Iain C Cranston
BACKGROUND: Indications for use of tolvaptan in SIADH-associated hyponatraemia remain controversial. We audited our local guidelines for Tolvaptan use in this situation to review treatment implications including drug safety, hospital admission episode analysis (episodes of liver toxicity, CNS myelinolysis, sodium-related re-admission rates), morbidity; mortality and underlying aetiologies. METHODS: We report a retrospective case series analysis of on-going treatment outcomes (case-note review) for 31 patients (age 73...
November 6, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29105594/tolvaptan-in-later-stage-autosomal-dominant-polycystic-kidney-disease
#7
Vicente E Torres, Arlene B Chapman, Olivier Devuyst, Ron T Gansevoort, Ronald D Perrone, Gary Koch, John Ouyang, Robert D McQuade, Jaime D Blais, Frank S Czerwiec, Olga Sergeyeva
BACKGROUND: In a previous trial involving patients with early autosomal dominant polycystic kidney disease (ADPKD; estimated creatinine clearance, ≥60 ml per minute), the vasopressin V2-receptor antagonist tolvaptan slowed the growth in total kidney volume and the decline in the estimated glomerular filtration rate (GFR) but also caused more elevations in aminotransferase and bilirubin levels. The efficacy and safety of tolvaptan in patients with later-stage ADPKD are unknown. METHODS: We conducted a phase 3, randomized withdrawal, multicenter, placebo-controlled, double-blind trial...
November 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29105553/tolvaptan-and-autosomal-dominant-polycystic-kidney-disease
#8
EDITORIAL
Julie R Ingelfinger
New England Journal of Medicine, Volume 377, Issue 20, Page 1988-1989, November 2017.
November 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29063302/effects-of-tolvaptan-on-urine-output-in-hospitalized-heart-failure-patients-with-hypoalbuminemia-or-proteinuria
#9
Koji Takagi, Naoki Sato, Shiro Ishihara, Michiko Sone, Hideo Tokuyama, Kenji Nakama, Toshiya Omote, Arifumi Kikuchi, Masahiro Ishikawa, Kenichi Amitani, Naoto Takahashi, Yuji Maruyama, Hajime Imura, Wataru Shimizu
Hypoalbuminemia is an independent prognostic factor in hospitalization for heart failure (HHF). Hypoalbuminemia or proteinuria is related to resistance to loop diuretics. Tolvaptan is an oral non-peptide, competitive antagonist of vasopressin receptor-2. It has been used for the treatment of volume overload in HHF patients in several Asian countries. Several studies have demonstrated marked improvement in congestion in HHF patients. However, whether tolvaptan is useful for HHF patients with hypoalbuminemia or proteinuria (both of which are related to resistance to loop diuretics) has not been clarified...
October 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29052786/tolvaptan-promotes-urinary-excretion-of-sodium-and-urea-a-retrospective-cohort-study
#10
Satoshi Minami, Takayuki Hamano, Hirotsugu Iwatani, Masayuki Mizui, Yoshiki Kimura, Yoshitaka Isaka
BACKGROUND: Tolvaptan (TLV) promotes aquaresis; however, little is known about its effect on solute excretion in chronic kidney disease (CKD). METHODS: We retrospectively studied CKD patients with decompensated heart failure (HF) or those with autosomal dominant polycystic kidney disease (ADPKD) receiving TLV. Patients with an increased urine volume of more than twice of daily variance were defined as "responders" in HF. We compared the ability of the urinary osmolality (U-OSM) change and urinary creatinine concentration ([U-Cr]) change to discriminate "responders"...
October 20, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29038464/unveiling-some-fda-approved-drugs-as-inhibitors-of-the-store-operated-ca-2-entry-pathway
#11
Saifur Rahman, Taufiq Rahman
The store-operated calcium entry (SOCE) pathway is an important route for generating cytosolic Ca(2+) signals that regulate a diverse array of biological processes. Abnormal SOCE seem to underlie several diseases that notably include allergy, inflammation and cancer. Therefore, any modulator of this pathway is likely to have significant impact in cell biology under both normal and abnormal conditions. In this study, we screened the FDA-approved drug library for agents that share significant similarity in 3D shape and surface electrostatics with few, hitherto best known inhibitors of SOCE...
October 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29034246/tolvaptan-for-the-treatment-of-enlarged-polycystic-liver-disease
#12
Hiroki Mizuno, Junichi Hoshino, Tatsuya Suwabe, Keiichi Sumida, Akinari Sekine, Yoichi Oshima, Masahiko Oguro, Kyohei Kunizawa, Masahiro Kawada, Rikako Hiramatsu, Noriko Hayami, Eiko Hasegawa, Masayuki Yamanouchi, Naoki Sawa, Kenmei Takaichi, Yoshifumi Ubara
A 44-year-old Japanese woman with autosomal dominant polycystic kidney disease was admitted to our hospital for evaluation of abdominal distension. Her eGFR was 53.7 mL/min/1.73 m(2). Total kidney volume was 2,614 mL. Tolvaptan (60 mg/day) was started to treat renal involvement. The patient's abdominal fullness began to improve and liver volume, indicating advanced polycystic liver disease (PLD), decreased from 9,750 mL to 8,345 mL after 17 months of tolvaptan treatment, though there was no significant change in kidney volume...
May 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29029277/mir-122-release-in-exosomes-precedes-overt-tolvaptan-induced-necrosis-in-a-primary-human-hepatocyte-micropatterned-coculture-model
#13
Merrie Mosedale, J Scott Eaddy, O Joseph Trask, Natalie S Holman, Kristina K Wolf, Edward LeCluyse, Brenton R Ware, Salman R Khetani, Jingtao Lu, William J Brock, Sharin E Roth, Paul B Watkins
Idiosyncratic drug-induced liver injury (IDILI) is thought to often result from an adaptive immune attack on the liver. However, it has been proposed that the cascade of events culminating in an adaptive immune response begins with drug-induced hepatocyte stress, release of exosomal danger signals, and innate immune activation, all of which may occur in the absence of significant hepatocelluar death. A micropatterned coculture model (HepatoPac®) was used to explore the possibility that changes in exosome content precede overt necrosis in response to the IDILI drug tolvaptan...
September 28, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28992127/can-we-further-enrich-autosomal-dominant-polycystic-kidney-disease-clinical-trials-for-rapidly-progressive-patients-application-of-the-propkd-score-in-the-tempo-trial
#14
Emilie Cornec-Le Gall, Jaime D Blais, Maria V Irazabal, Olivier Devuyst, Ron T Gansevoort, Ron D Perrone, Arlene B Chapman, Frank S Czerwiec, John Ouyang, Christina M Heyer, Sarah R Senum, Yannick Le Meur, Vicente E Torres, Peter C Harris
Background: The PROPKD score has been proposed to stratify the risk of progression to end-stage renal disease in autosomal dominant polycystic kidney disease (ADPKD) subjects. We aimed to assess its prognostic value in a genotyped subgroup of subjects from the Tolvaptan Phase 3 Efficacy and Safety Study in Autosomal Dominant Polycystic Kidney Disease (TEMPO3/4) trial. Methods: In the post hoc analysis, PKD1 and PKD2 were screened in 770 subjects and the PROPKD score was calculated in mutation-positive subjects (male: 1 point; hypertension <35 years: 2 points; first urologic event <35 years: 2 points; nontruncating PKD1 mutation: 2 points; truncating PKD1 mutation: 4 points)...
July 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28984014/increased-serum-c-reactive-protein-and-decreased-urinary-aquaporin-2-levels-are-predictive-of-the-efficacy-of-tolvaptan-in-patients-with-liver-cirrhosis
#15
Masato Nakai, Koji Ogawa, Rei Takeda, Masatsugu Ohara, Naoki Kawagishi, Takaaki Izumi, Machiko Umemura, Jun Ito, Takuya Sho, Goki Suda, Kenichi Morikawa, Naoya Sakamoto
AIM: Water retention, hepatic ascites, and peripheral edema are significant problems in patients with liver cirrhosis (LC). Although furosemide and spironolactone are commonly used as treatment, these are often insufficient to treat hyponatremia and renal insufficiency in patients with LC. Tolvaptan (TVP) could provide an effective treatment alternative. However, predictive factors of a therapeutic response to TVP are unclear. Our aim was to examine clinical predictors of the response to TVP in patients with LC and water retention...
October 6, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28943585/the-outcome-of-cirrhotic-patients-with-ascites-is-improved-by-the-normalization-of-the-serum-sodium-level-by-tolvaptan
#16
Tomomi Kogiso, Mutsuki Kobayashi, Kuniko Yamamoto, Yuichi Ikarashi, Kazuhisa Kodama, Makiko Taniai, Nobuyuki Torii, Etsuko Hashimoto, Katsutoshi Tokushige
Objectives Hyponatremia is frequently observed in patients with decompensated liver cirrhosis and it is also related to a poor prognosis. The vasopressin V2-receptor antagonist tolvaptan is used to treat cirrhotic patients with ascites and increases the serum sodium (Na) level. In this study, we investigated (i) whether or not correction of the Na level improves the prognosis of cirrhotic patients with ascites and (ii) predictors of normalization of the serum Na level after tolvaptan therapy. Methods This was a single-center retrospective study...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28939928/acute-heart-failure-an-unmet-medical-need
#17
REVIEW
A G Rigopoulos, C Bakogiannis, R de Vecchis, S Sakellaropoulos, M Ali, M Teren, M Matiakis, C Tschoepe, M Noutsias
Despite recent advances in the management of heart failure with reduced ejection fraction (HFrEF), the burden of acute heart failure (AHF) remains significant with a high morbidity and mortality that has not been improved by any treatment modality. A meta-analysis summarized the study results on the effects of tolvaptan on AHF, which failed to demonstrate an improvement in short-term and long-term mortality, length of hospital stay and reduced frequency of worsening heart failure (WHF). Similar trial results were also reported in other AHF studies, such as the ASCEND-HF and the RELAX-AHF-2 trials...
September 22, 2017: Herz
https://www.readbyqxmd.com/read/28905441/the-vasopressin-system-new-insights-for-patients-with-kidney-diseases-epidemiological-evidence-and-therapeutic-perspectives
#18
REVIEW
W F Clark, O Devuyst, R Roussel
People with chronic kidney disease (CKD) are at risk of severe outcomes, such as end-stage renal disease or cardiovascular disease, and CKD is a globally increasing health burden with a high personal and economic cost. Despite major progresses in prevention and therapeutics in last decades, research is still needed to reverse this epidemic trend. The regulation of water balance and the state of activation of the vasopressin system have emerged as factors tightly associated with kidney health, in the general population but also in specific conditions; among them, various stages of CKD, diabetes and autosomal dominant polycystic kidney disease (ADPKD)...
October 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28898297/effects-and-safety-of-oral-tolvaptan-in-patients-with-congestive-heart-failure-a-systematic-review-and-network-meta-analysis
#19
REVIEW
Mei-Yi Wu, Tzu-Ting Chen, Ying-Chun Chen, Der-Cherng Tarng, Yun-Chun Wu, Hsien-Ho Lin, Yu-Kang Tu
AIMS: Several studies reported treatment benefits of tolvaptan in patients with congestive heart failure (CHF). However, the optimal dosage remains unclear. We aimed to compare different dosage of tolvaptan to determine the optimal dosage in terms of the efficacy and safety. METHODS: We searched MEDLINE, PubMed, EMBASE, Cochrane CENTRAL and ClinicalTrials.gov through Aug 31, 2016. Randomized controlled trials (RCTs) comparing tolvaptan of different dosages or to placebo in patients with CHF were included...
2017: PloS One
https://www.readbyqxmd.com/read/28889231/favorable-effects-of-early-tolvaptan-administration-in-very-elderly-patients-after-repeat-hospitalizations-for-acute-decompensated-heart-failure
#20
Masaki Kinoshita, Hideki Okayama, Tetsuya Kosaki, Saki Hosokawa, Go Kawamura, Tatsuya Shigematsu, Tatsunori Takahashi, Yoshitaka Kawada, Go Hiasa, Tadakatsu Yamada, Hiroshi Matsuoka, Yukio Kazatani
Tolvaptan (TLV) is an oral selective vasopressin 2 receptor antagonist that acts on the distal nephrons, causing a loss of electrolyte-free water. To date, its early administration in very elderly patients after repeat hospitalizations for acute decompensated heart failure (ADHF) despite receiving optimal medical therapy has not been evaluated. Fifty-six ADHF patients who were >80 years old and had been repeatedly hospitalized were retrospectively enrolled in this study. Twenty-five patients (14 men; mean age 86...
September 9, 2017: Heart and Vessels
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