• 1.

    Schrier RW, et al. Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med 2006; 355:20992112. doi: 10.1056/NEJMoa065181

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Berl T, et al. Oral tolvaptan is safe and effective in chronic hyponatremia. J Am Soc Nephrol 2010; 21:705712. doi: 10.1681/ASN.2009080857. Erratum in: J Am Soc Nephrol 2010; 21:1407. https://jasn.asnjournals.org/content/21/8/1407.2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Torres VE, et al. Tolvaptan in patients with autosomal dominant polycystic kidney disease. N Engl J Med 2012; 367:24072418. doi: 10.1056/NEJMoa1205511

  • 4.

    Torres VE, et al. Tolvaptan in later-stage autosomal dominant polycystic kidney disease. N Engl J Med 2017; 377:19301942. doi: 10.1056/NEJMoa1710030

  • 5.

    Edwards ME, et al. Long-term administration of tolvaptan in autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol 2018; 13:11531161. doi: 10.2215/CJN.01520218

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Malhotra I, et al. Unpredictable nature of tolvaptan in treatment of hypervolemic hyponatremia: Case review on role of vaptans. Case Rep Endocrinol 2014; 2014:807054. doi: 10.1155/2014/807054

    • Search Google Scholar
    • Export Citation
  • 7.

    Sterns RH. Tolvaptan for the syndrome of inappropriate secretion of antidiuretic hormone: Is the dose too high? Am J Kidney Dis 2018; 71:763765. doi: 10.1053/j.ajkd.2018.02.355

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Erickson KF, et al. Cost-effectiveness of tolvaptan in autosomal dominant polycystic kidney disease. Ann Intern Med 2013; 159:382389. doi: 10.7326/L14-5001-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Jamookeeah C, et al. Cost-effectiveness of tolvaptan for the treatment of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion in Sweden. BMC Endocr Disord 2016; 16:22. doi: 10.1186/s12902-016-0104-z

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Chebib FT, et al. A practical guide for treatment of rapidly progressive ADPKD with tolvaptan. J Am Soc Nephrol 2018; 29:24582470. doi: 10.1681/ASN.2018060590

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Gross P, et al. Con: Tolvaptan for autosomal dominant polycystic kidney disease—do we know all the answers? Nephrol Dial Transplant 2019; 34:3537. doi: 10.1093/ndt/gfy298

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Meijer E, Gansevoort RT. Vasopressin V2 receptor antagonists in autosomal dominant polycystic kidney disease: Efficacy, safety, and tolerability. Kidney Int 2020; 98:289293. doi: 10.1016/j.kint.2020.03.023

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Gordon CE, Perrone RD. Tolvaptan or transplant: Why wait? Kidney Int 2020; 98:286289. doi:10.1016/j.kint.2020.03.022.Erratum in: Kidney Int 2020; 98:1622. doi: 10.1016/j.kint.2020.11.002

    • Crossref
    • Search Google Scholar
    • Export Citation

Light and Shadow in Oral Tolvaptan Treatment

  • 1 Yong Chul Kim is an associate professor and Hajeong Lee is a professor in the Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Restricted access

Tolvaptan, an oral selective vasopressin V2 receptor antagonist, was approved by the US Food and Drug Administration (FDA) for the treatment of clinically significant hypervolemic or euvolemic hyponatremia and rapidly progressing autosomal dominant polycystic kidney disease (ADPKD). It antagonizes the effect of an arginine vasopressin (antidiuretic hormone), which has a key role in water and circulatory homeostasis in the collecting duct of the kidney. Tolvaptan leads to an increase in urine water excretion (aquaresis) that results in enhanced free-water clearance in states of relative vasopressin excess, increasing serum sodium concentrations. Additionally, tolvaptan induces a reduction in cyclic adenosine monophosphate (cAMP),

Save