Recommendations for the use of tolvaptan in autosomal dominant polycystic kidney disease: a position statement on behalf of the ERA-EDTA Working Groups on Inherited Kidney Disorders and European Renal Best Practice
Por:
Gansevoort, RT, Arici, M, Benzing, T, Birn, H, Capasso, G, Covic, A, Devuyst, O, Drechsler, C, Eckardt, KU, Emma, F, Knebelmann, B, Le Meur, Y, Massy, ZA, Ong, ACM, Ortiz, A, Schaefer, F, Torra, R, Vanholder, R, Wiecek, A, Zoccali, C, Van Biesen, W
Publicada:
1 mar 2016
Resumen:
Recently, the European Medicines Agency approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency of autosomal dominant polycystic kidney disease (ADPKD) in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease. In this paper, on behalf of the ERA-EDTA Working Groups of Inherited Kidney Disorders and European Renal Best Practice, we aim to provide guidance for making the decision as to which ADPKD patients to treat with tolvaptan. The present position statement includes a series of recommendations resulting in a hierarchical decision algorithm that encompasses a sequence of risk-factor assessments in a descending order of reliability. By examining the best-validated markers first, we aim to identify ADPKD patients who have documented rapid disease progression or are likely to have rapid disease progression. We believe that this procedure offers the best opportunity to select patients who are most likely to benefit from tolvaptan, thus improving the benefit-to-risk ratio and cost-effectiveness of this treatment. It is important to emphasize that the decision to initiate treatment requires the consideration of many factors besides eligibility, such as contraindications, potential adverse events, as well as patient motivation and lifestyle factors, and requires shared decision-making with the patient.
Filiaciones:
Gansevoort, RT:
Univ Groningen, Univ Med Ctr Groningen, Dept Nephrol, Groningen, Netherlands
Arici, M:
Hacettepe Univ, Fac Med, Dept Nephrol, TR-06100 Ankara, Turkey
Benzing, T:
Univ Cologne, Dept Internal Med 2, D-50931 Cologne, Germany
Univ Cologne, Ctr Mol Med Cologne, D-50931 Cologne, Germany
Birn, H:
Aarhus Univ Hosp, Dept Renal Med, DK-8000 Aarhus, Denmark
Aarhus Univ, Dept Biomed, Aarhus, Denmark
Capasso, G:
Univ Naples 2, Dept Nephrol, Naples, Italy
Covic, A:
CI PARHON Univ Hosp, Dialysis & Renal Transplant Ctr, Nephrol Clin, Iasi, Romania
Grigore T Popa Univ Med, Iasi, Romania
Devuyst, O:
Univ Zurich, Inst Physiol, Zurich, Switzerland
Catholic Univ Louvain, Sch Med, Div Nephrol, B-1200 Brussels, Belgium
Drechsler, C:
Univ Wurzburg, Univ Hosp, Div Renal, D-97070 Wurzburg, Germany
Eckardt, KU:
Univ Erlangen Nurnberg, Dept Hypertens & Nephrol, Erlangen, Germany
Emma, F:
Bambino Gesu Pediat Hosp, IRCCS, Dept Nephrol & Urol, Rome, Italy
Knebelmann, B:
Paris Descartes Univ, Hop Necker, Dept Nephrol, Paris, France
Le Meur, Y:
CHRU, Hop La Cavale Blanche, Serv Nephrol Hemodialyse & Transplantat Renale, Brest, France
Massy, ZA:
Hop Ambroise Pare, AP HP, Div Nephrol, Boulogne, France
Inserm U 1018, Equipe 5, Villejuif, France
Univ Paris Saclay & Paris Ouest Versailles St Que, Paris, France
Ong, ACM:
Univ Sheffield, Sch Med, Acad Nephrol Unit, Sheffield, S Yorkshire, England
Ortiz, A:
UAM, IIS Fdn Jimenez Diaz, Madrid, Spain
REDINREN, Madrid, Spain
Schaefer, F:
Univ Heidelberg Hosp, Ctr Pediat & Adolescent Med, Pediat Nephrol Div, Heidelberg, Germany
Torra, R:
Univ Autonoma Barcelona, Fundacio Puigvert Inst Invest Biomed St Pau, Inherited Kidney Dis Nephrol Dept, E-08193 Barcelona, Spain
REDINREN, Barcelona, Spain
Vanholder, R:
Ghent Univ Hosp, Div Renal, Ghent, Belgium
Wiecek, A:
Med Univ Silesia, Dept Nephrol Transplantat & Internal Med, Katowice, Poland
Zoccali, C:
Osped Riuniti Reggio Calabria, CNR IFC, Clin Epidemiol & Pathophysiol Renal Dis & Hyperte, Reggio Di Calabria, Italy
Van Biesen, W:
Ghent Univ Hosp, Div Renal, Ghent, Belgium
Green Published, Hybrid Gold, Green Accepted
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