Review of the REPRISE Trial: Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease
Journal Title: Nephrology – Open Journal - Year 2018, Vol 4, Issue 1
Abstract
In the past, Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease (ADPKD) and its Outcomes (TEMPO) trial showed Tolvaptan, a vasopressin V2-receptor antagonist, slowed the decline in the estimated Glomerular Filtration Rate (eGFR) in patients with estimated creatinine clearance of ≥60 ml per minute. With this in consideration, Replicating Evidence of Preserved Renal Function: Investigation of Tolvaptan Safety and Efficacy (REPRISE) trial was conducted to assess the efficacy and safety of Tolvaptan in patients with later stage ADPKD. In this trial, 1370 patients with later-stage ADPKD were randomized. These patients were either 18 to 55-years-old with eGFR of 25 to 65 mL per minute per 1.73 m2 of body surface area or 56 to 65-years-old with eGFR of 25 to 44 mL per minute per 1.73 m2 . The primary end-point of this trial was the change in eGFR between baseline and end of trial period, with adjustments made for exact duration that each patient participated for, interpolated to 1 year. The change from baseline that was noted in the Tolvaptan group was -2.34 mL per minute per 1.73 m2 vs. -3.61 mL per minute per 1.73 m2 in the placebo group. A difference of 1.27 mL per minute per 1.73 m2 (95% CI, p less than 0.001) was noted. Based on the data collected by the REPRISE trial over a 1-year period, it can be concluded that Tolvaptan slows the decline in eGFR than placebo in patients with later stage ADPKD.
Authors and Affiliations
Soroush Nomigolzar, Himax Patel
Keywords
Related Articles
- EP ID EP558760
- DOI 10.17140/NPOJ-4-119
- Views 157
- Downloads 0
Individualized Sodium Prescription inHemodialysis: An Ally for Better DialysisOutcomes?
The current practice in dialysis centres all over the world is to use standard sodium dialysate for all patients. Recently, there is a lot of interest in manipulating the dialysate sodium concentration to reduce fluid ov...
Variation of Peripheral Th17/Treg Imbalance in Patients with Idiopathic Membranous Nephropathy after Cyclosporin A Treatment: A Prognostic Marker of Idiopathic Membranous Nephropathy
Despite impressive improvements in the 1-year graft survival for kidney transplantation, which has risen from 60% to 95% over the last few decades, little progress has been made in long-term graft survival. Half of the g...
Effect of Diethylenetriaminepentaacetic Acid (DTPA) on Crystal Growth and Morphology of Calcium Oxalate
Introduction: One of the most common and painful diseases observed in the tropical regions is kidney stone formation. This can be due to various factors such as the amount of water consumption, climatic conditions, lifes...
Involvement of NF-κB Signaling Pathway in the Pathogenesis of Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by accumulation of anti-nuclear autoantibodies, hyperactivation. It can affect any organ, including brain, skin, joint, and kidney. The nu...
Depression in Dialysis
When was the last time you talked to your dialysis patient about depression? And what prompted you to start the conversation? It may be that our patients are not talking to us about the way they feel regarding the treatm...