在ADPKD中使用托尔瓦普坦的功能轨迹 患有CKD-G5的患者
Akinari Sekine1,2, Junichi Hoshino3, Toshio Mochizuki4
1Nephrology Center, Toranomon Hospital, Tokyo, Japan.
Kidney international reports
|July 9, 2025
概括
持续低剂量托尔瓦普坦稳定了自体主导多囊性病 (ADPKD) 患者的预计球过率 (eGFR) 斜率,这些患者患有晚期慢性病 (CKD-G5). 在这些患者中,停止托尔瓦普坦治疗加速了功能下降.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
- 遗传学 是一个遗传学.
背景情况:
- 托尔瓦普坦改善了自体主导多囊性病 (ADPKD) 中估计的淋巴细胞过率 (eGFR) 斜率.
- 在日本,高剂量托尔瓦普坦在慢性病G5 (CKD-G5) 阶段停止使用.
- 在CKD-G5心力衰竭和功能衰竭患者中,低剂量托尔瓦普坦可以继续使用.
研究的目的:
- 为了研究持续低剂量托尔瓦普坦对ADPKD患者的功能的影响,这些患者达到CKD-G5.5.
- 为了比较ADPKD患者的eGFR斜率,这些患者在CKD-G5.5继续,停止或从未接受过tolvaptan.
主要方法:
- 一个日本全国性的,多中心的,回顾性观察性研究.
- 包括110名发展为CKD-G5的ADPKD患者.
- 患者被分为:继续服用托尔瓦普坦 (在CKD-G时≤15毫克/天),停止服用托尔瓦普坦和不服用托尔瓦普坦的组.
主要成果:
- 在非托尔瓦普坦组中,eGFR斜率保持稳定.
- 与之前相比,在托尔瓦普坦停用组中,eGFR斜率在CKD-G5期间加速.
- 在tolvaptan继续组中,eGFR斜率从CKD-G5之前到CKD-G5期间保持稳定.
结论:
- 继续服用低剂量托尔瓦普坦可能会在患有CKD-G5.5的ADPKD患者中保持功能.
- 在CKD-G5中停止使用托尔瓦普坦显著恶化了eGFR斜率.
- 需要进行临床试验,以确认持续低剂量托尔瓦普坦的疗效和安全性.
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