Tolvaptan treatment is associated with altered mineral metabolism parameters and increased bone mineral density in ADPKD patients.

Autor:	Bargagli M; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Università Cattolica del Sacro Cuore, Rome, Italy.; U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Vetsch A; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Anderegg MA; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Dhayat NA; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Huynh-Do U; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Faller N; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Vogt B; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Ferraro PM; Università Cattolica del Sacro Cuore, Rome, Italy.; U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Fuster DG; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2023 Jun 30; Vol. 38 (7), pp. 1645-1654.
DOI:	10.1093/ndt/gfac298
Abstrakt:	Background: Autosomal dominant polycystic kidney disease (ADPKD) is characterized by a unique bone and mineral phenotype. The impact of tolvaptan treatment on mineral metabolism and bone mineral density (BMD) is unknown. Methods: We conducted an analysis in the Bern ADPKD Registry, a prospective observational cohort study. Mineral metabolism parameters were measured at baseline and every 12 months thereafter. BMD was determined by dual-energy X-ray absorptiometry at baseline and after 3 years. Multivariable mixed-effects regression models were applied to assess changes in mineral metabolism parameters and BMD associated with tolvaptan treatment. Results: A total of 189 participants (122 without and 67 with subsequent tolvaptan treatment) were included in the analysis. During follow-up, tolvaptan treatment was associated with increased BMD at the femoral neck {β = 0.092 [95% confidence interval (CI) 0.001-0.183], P = .047}. In addition, tolvaptan treatment was associated with higher plasma magnesium [β = 0.019 (95% CI 0.001-0.037), P = .037], bicarbonate [β = 0.972 (95% CI 0.242-1.702), P = .009] and urine pH [β = 0.214 (95% CI 0.056-0.372), P = .008] and lower parathyroid hormone [β = -0.191 (95% CI -0.328 to -0.053), P = .006], 1,25(OH)D3 [β = -0.126 (95% CI -0.235 to -0.164), P = .024] and fractional urinary magnesium excretion [β = -0.473 (95% CI -0.622 to -0.324), P < .001]. Conclusions: Chronic tolvaptan treatment is associated with increased femoral BMD and significant changes in both mineral metabolism and acid-base parameters in ADPKD patients. (© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu