SP032
TWO YEARS EXPERIENCE OF TOLVAPTAN TREATMENT FOR TWENTY-THREE ADPKD PATIENTS

Introduction and Aims: This report is to disclose our experience of the tolvaptan treatment since April of 2014. The department specialized in ADPKD has been provided in our hospital since January of 2014, in response to the new agent era.

Methods: The clinical record and charts were reviewed in all the patients with ADPKD whom the tolvaptan treatment was prescribed in our department.

Results: At present (January of 2016), eighty-three patients & family members have visited our clinic since January of 2014. Most people inquired about the new treatment of tolvaptan, while some requested the genetic counselling. Forty patients fully filled the tolvaptan treatment criteria for ADPKD issued by Japanese Ministry of Health, Labour and Welfare (GFR>15ml/min/1.73m², Total kidney volume , TKV, >750ml, and the annual volume expanding rate >5%). Amongst them, twenty-three patients (seven males, aged 38-63, eGFR 16.8-78.6ml/min/1.73m²) have decided themselves and started the tolvaptan treatment with ADPKD. Two patients developed the liver damage, and halted the treatment with tolvaptan at six and seven months after the initiation, respectively. The stopping of the agent resulted in full improvement in both patients. Other twenty-one patients have still continued the treatment. The approximate straights of eGFR one to two years before and after the new treatment initiation were used to evaluate the effect of tolvaptan on renal function among ten patients who had been treated over one year. In five patients, the deterioration of kidney function was significantly suppressed, while in three such benefit was not found in this evaluation method. The volumetric evaluation of CT images in these ten patients showed the significant reduction of TKV in four patients, conversely in two patients the TKV was significantly increased during the treatment.

Conclusions: It seems worthy for the ADPKD patients to choice this treatment with tolvaptan, in case they are aggressive, although it compels patient and can change their QOL.