Evaluation of the Renal and Cardiovascular Effects of Long-Term Tolvaptan Treatment in Autosomal Dominant Polycystic Kidney Disease.

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiorenal Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-29 DOI:10.1159/000538098

Alparslan Demiray, Ramazan Ozan, Salih Güntuğ Özaytürk, Hakan İmamoğlu, Gökmen Zararsız, Murat Hayri Sipahioğlu, Bülent Tokgöz, Deniz Elçik, İsmail Koçyiğit

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Abstract

Introduction: Cardiovascular diseases constitute a significant cause of morbidity and mortality in individuals with autosomal dominant polycystic kidney disease (ADPKD). This study aimed to assess the long-term effects of tolvaptan on the kidneys and heart in rapidly progressing ADPKD.

Methods: Among 354 patients diagnosed with ADPKD, 58 meeting the eligibility criteria for tolvaptan were included in the study. The study comprised two groups with similar demographic and clinical characteristics: 29 patients receiving tolvaptan treatment and 29 in the control group. Several included genetic analysis, magnetic resonance imaging, and echocardiography. Clinical and cardiac changes were recorded in both groups after a 3-year follow-up.

Results: Tolvaptan treatment demonstrated a significant reduction in the rate of eGFR decline compared to the control group. Furthermore, it was observed that tolvaptan could prevent the development of cardiac arrhythmias by inhibiting an increase in QTc interval and heart rate.

Conclusion: These findings suggest that, in addition to slowing kidney progression in ADPKD management, tolvaptan may potentially benefit in preventing cardiac complications.

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评估长期托伐普坦治疗常染色体显性多囊肾对肾脏和心血管的影响

背景/目的：心血管疾病是常染色体显性多囊肾（ADPKD）患者发病和死亡的重要原因。本研究旨在评估托伐普坦对快速进展的 ADPKD 患者的肾脏和心脏的长期影响：在354名确诊为ADPKD的患者中，有58名符合托伐普坦的资格标准。研究包括人口统计学和临床特征相似的两组：29 名患者接受托伐普坦治疗，29 名患者为对照组。几项研究包括基因分析、磁共振成像（MRI）和超声心动图。随访三年后，记录了两组患者的临床和心脏变化：结果：与对照组相比，托伐普坦治疗显著降低了 eGFR 的下降率。此外，还观察到托伐普坦可以通过抑制 QTc 间期和心率的增加来防止心律失常的发生：这些研究结果表明，在 ADPKD 的治疗过程中，托伐普坦除了能延缓肾脏的恶化，还能预防心脏并发症。

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来源期刊

Cardiorenal Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-UROLOGY & NEPHROLOGY

CiteScore

5.40

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The journal ''Cardiorenal Medicine'' explores the mechanisms by which obesity and other metabolic abnormalities promote the pathogenesis and progression of heart and kidney disease (cardiorenal metabolic syndrome). It provides an interdisciplinary platform for the advancement of research and clinical practice, focussing on translational issues.