Mónica Furlano1, Irene Loscos2, Teresa Martí3, Gemma Bullich4, Nadia Ayasreh1, Asunción Rius1,5, Lourdes Roca1,6, José Ballarín7, Elisabet Ars4, Roser Torra1. 1. Department of Nephrology, Inherited Renal Disorders, Fundació Puigvert, REDINREN, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 2. Universitat Pompeu Fabra-Universitat Autònoma de Barcelona, Barcelona, Spain. 3. Department of Radiology, Fundació Puigvert, Barcelona, Spain. 4. Molecular Biology Laboratory, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Barcelona, Spain. 5. Department of Nephrology, Hospital General Universitario de Castellón, Castellón, Spain. 6. Hospital Universitario y Politécnico de La Fe, Valencia, Spain. 7. Department of Nephrology, Fundació Puigvert, REDinREN, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Abstract
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) causes the development of renal cysts and leads to a decline in renal function. Limited guidance exists in clinical practice on the use of tolvaptan. A decision algorithm from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Working Groups of Inherited Kidney Disorders and European Renal Best Practice (WGIKD/ERBP) has been proposed to identify candidates for tolvaptan treatment; however, this algorithm has not been assessed in clinical practice. METHODS: Eighteen-month cross-sectional, unicenter, observational study assessing 305 consecutive ADPKD patients. The ERA-EDTA WGIKD/ERBP algorithm with a stepwise approach was used to assess rapid progression (RP). Subsequently, expanded criteria based on the REPRISE trial were applied to evaluate the -impact of extended age (≤55 years) and estimated glomerular filtration rate (eGFR; ≥25 mL/min/1.73 m2). RESULTS: Historical eGFR decline, indicative of RP, was fulfilled in 26% of 73 patients who were candidates for RP assessment, mostly aged 31-55 years. Further tests including ultrasound and MRI measurements of kidney volume plus genetic testing enabled the evaluation of the remaining patients. Overall, 15.7% of patients met the criteria for rapid or likely RP using the algorithm, and the percentage increased to 27% when extending age and eGFR. CONCLUSIONS: The ERA-EDTA WGIKD/ERBP algorithm provides a valuable means of identifying in routine clinical practice patients who may be eligible for treatment with tolvaptan. The impact of a new threshold for age and eGFR may increase the percentage of patients to be treated.
BACKGROUND:Autosomal dominant polycystic kidney disease (ADPKD) causes the development of renal cysts and leads to a decline in renal function. Limited guidance exists in clinical practice on the use of tolvaptan. A decision algorithm from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Working Groups of Inherited Kidney Disorders and European Renal Best Practice (WGIKD/ERBP) has been proposed to identify candidates for tolvaptan treatment; however, this algorithm has not been assessed in clinical practice. METHODS: Eighteen-month cross-sectional, unicenter, observational study assessing 305 consecutive ADPKDpatients. The ERA-EDTA WGIKD/ERBP algorithm with a stepwise approach was used to assess rapid progression (RP). Subsequently, expanded criteria based on the REPRISE trial were applied to evaluate the -impact of extended age (≤55 years) and estimated glomerular filtration rate (eGFR; ≥25 mL/min/1.73 m2). RESULTS: Historical eGFR decline, indicative of RP, was fulfilled in 26% of 73 patients who were candidates for RP assessment, mostly aged 31-55 years. Further tests including ultrasound and MRI measurements of kidney volume plus genetic testing enabled the evaluation of the remaining patients. Overall, 15.7% of patients met the criteria for rapid or likely RP using the algorithm, and the percentage increased to 27% when extending age and eGFR. CONCLUSIONS: The ERA-EDTA WGIKD/ERBP algorithm provides a valuable means of identifying in routine clinical practice patients who may be eligible for treatment with tolvaptan. The impact of a new threshold for age and eGFR may increase the percentage of patients to be treated.
Authors: Roman-Ulrich Müller; A Lianne Messchendorp; Henrik Birn; Giovambattista Capasso; Emilie Cornec-Le Gall; Olivier Devuyst; Albertien van Eerde; Patrick Guirchoun; Tess Harris; Ewout J Hoorn; Nine V A M Knoers; Uwe Korst; Djalila Mekahli; Yannick Le Meur; Tom Nijenhuis; Albert C M Ong; John A Sayer; Franz Schaefer; Aude Servais; Vladimir Tesar; Roser Torra; Stephen B Walsh; Ron T Gansevoort Journal: Nephrol Dial Transplant Date: 2022-04-25 Impact factor: 7.186
Authors: Javier Naranjo; Mónica Furlano; Ferran Torres; Jonathan Hernandez; Marc Pybus; Laia Ejarque; Christian Cordoba; Lluis Guirado; Elisabet Ars; Roser Torra Journal: Clin Kidney J Date: 2021-12-28
Authors: David K E Lim; James H Boyd; Elizabeth Thomas; Aron Chakera; Sawitchaya Tippaya; Ashley Irish; Justin Manuel; Kim Betts; Suzanne Robinson Journal: PLoS One Date: 2022-07-26 Impact factor: 3.752
Authors: Sara S Jdiaa; Nedaa M Husainat; Razan Mansour; Mohamad A Kalot; Kerri McGreal; Fouad T Chebib; Ronald D Perrone; Alan Yu; Reem A Mustafa Journal: Kidney Int Rep Date: 2022-07-05