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
Gansevoort, Ron T.. (University Medical Center Groningen, University of Groningen)
Arici, Mustafa (Hacettepe University Faculty of Medicine)
Benzing, Thomas (University of Cologne)
Birn, Henrik (Aarhus University)
Capasso, Giovambattista (Second University of Naples)
Covic, Adrian (and 'Grigore T. Popa' University of Medicine. C.I. PARHON' University Hospital)
Devuyst, Olivier (UCL Medical School)
Drechsler, Christiane (University Hospital. University of Würzburg)
Eckardt, Kai-Uwe (Friedrich-Alexander University Erlangen-Nürnberg (FAU))
Emma, Francesco (Bambino Gesù Children's Hospital)
Knebelmann, Bertrand (Paris Descartes University. Hôpital Necker)
Le Meur, Yannick (Hôpital La Cavale Blanche, Centre Hospitalier Régional Universitaire de Brest)
Massy, Ziad A. (University of Paris Saclay and Paris Ouest-Versailles-Saint-Quentin-en-Yvelines (UVSQ))
Ong, Albert C. M. (University of Sheffield Medical School)
Ortiz, Alberto (Red de Investigación Renal)
Schaefer, Franz (Heidelberg University Hospital (Alemanya))
Torra Balcells, Roser (Institut d'Investigació Biomèdica Sant Pau)
Vanholder, Raymond (Universitair Ziekenhuis Gent)
Więcek, Andrzej (Medical University of Silesia in Katowice)
Zoccali, Carmine (CNR-IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension Unit, Reggio Calabria c/o Ospedali Riuniti)
Van Biesen, Wim (Universitair Ziekenhuis Gent)
Universitat Autònoma de Barcelona
Institut Puigvert

Data:	2016
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	ADPKD ; Tolvaptan ; Vasopressin V2 receptor antagonist
Publicat a:	Nephrology Dialysis Transplantation, Vol. 31 (january 2016) , p. 337-348, ISSN 1460-2385

DOI: 10.1093/ndt/gfv456
PMID: 26908832

12 p, 666.2 KB

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