Creatine Kinase Elevation in Autosomal Dominant Polycystic Kidney Disease Patients on Tolvaptan Treatment

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of end-stage kidney disease. Currently, tolvaptan is the only treatment that has proven to delay disease progression. The most notable side effect of this therapy is drug-induced liver injury; however, recently,...

Descripción completa

Detalles Bibliográficos
Autores: Rodríguez-Espinosa, Diana, Broseta, José Jesús|||0000-0002-4559-9083, Bastida, Carla|||0000-0003-0845-8107, Álvarez Mora, María Isabel|||0000-0003-3788-8915, Nicolau, Carlos|||0000-0002-1381-6442, Alvarez, Cristina, Agraz Pamplona, Irene|||0000-0002-4223-6834, Sánchez-Baya, Maya|||0000-0003-1689-9383, Furlano, Monica|||0000-0003-1025-3901, Ruiz, César, Quintana, Luis F.|||0000-0001-7582-8476, Piñeiro, Gastón Julio|||0000-0003-3806-4731, Poch, Esteban|||0000-0002-6492-024X, Torra Balcells, Roser|||0000-0001-8714-2332, Blasco Pelicano, Miquel|||0000-0003-0789-7992
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:281651
Acceso en línea:https://ddd.uab.cat/record/281651
https://dx.doi.org/urn:doi:10.1159/000526368
Access Level:acceso abierto
Palabra clave:ADPKD
Creatine-kinase
Side effect
Tolvaptan
Descripción
Sumario:Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of end-stage kidney disease. Currently, tolvaptan is the only treatment that has proven to delay disease progression. The most notable side effect of this therapy is drug-induced liver injury; however, recently, there have been two reports of creatine kinase (CK) elevation in ADPKD patients on tolvaptan treatment. We set out to monitor and determine the actual incidence of CK elevation and evaluate its potential association with other clinical factors. This is an observational retrospective multicenter study performed in rapidly progressive ADPKD patients on tolvaptan treatment from Barcelona, Spain. Laboratory tests, demographics, treatment dose, and reported symptoms were collected from October 2018 to March 2021. Ninety-five patients initiated tolvaptan treatment during follow-up. The medication had to be discontinued in 31 (32.6%) patients, primarily due to aquaretic effects (12.6%), elevated liver enzymes (8.4%), and symptomatic or persistently elevated CK levels (3.2%). Moreover, a total of 27 (28.4%) patients had elevated CK levels, with most of them being either transient (12.6%), mild and asymptomatic (4.2%), or resolved after dose reduction (3.2%) or temporary discontinuation (2.1%). We pre sent the largest cohort that has monitored CK levels in a real-life setting, finding them elevated in 28.4% of patients. More research and monitoring will help us understand the clinical implications and the pathophysiological mechanism of CK elevation in this population.

Similares en LA Referencia