On 2017 Nov 22, NephJC - Nephrology Journal Club commented:

The trial of Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease was discussed on November 14th and 15th 2017 on #NephJC, the open online nephrology journal club. Introductory comments written by Ian Logan are available at the NephJC website here and a patient perspective is available here.

160 people participated in the discussion with an impressive 1215 tweets.

The highlights of the tweetchat were:

• In general, tolvaptan is still not routinely used, limited by lack of approval, concerns regarding cost-effectiveness, and patient tolerance in presymptomatic CKD.

• This was a well-designed study but one year may be too short an interval to evaluate at given that ADPKD is a lifelong disease.

• The benefit is mainly driven by stage 3a group. In stage 3b & 4 the change in GFR decline was between 0.78-0.81 ml/min

• The results overall are promising for Tolvaptan particularly if it can delay ESRD by a few years to allow time for pre-emptive transplant but concerns still remain regarding patient selection, tolerance, and the haemodynamic drop in GFR mediated by the drug.

Transcripts of the tweetchats, and curated versions as storify are available from the NephJC website.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC on twitter, liking @NephJC on facebook, signing up for the mailing list, or just visit the webpage at NephJC.com.

On 2017 Nov 22, NephJC - Nephrology Journal Club commented:

The trial of Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease was discussed on November 14th and 15th 2017 on #NephJC, the open online nephrology journal club. Introductory comments written by Ian Logan are available at the NephJC website here and a patient perspective is available here.

160 people participated in the discussion with an impressive 1215 tweets.

The highlights of the tweetchat were:

• In general, tolvaptan is still not routinely used, limited by lack of approval, concerns regarding cost-effectiveness, and patient tolerance in presymptomatic CKD.

• This was a well-designed study but one year may be too short an interval to evaluate at given that ADPKD is a lifelong disease.

• The benefit is mainly driven by stage 3a group. In stage 3b & 4 the change in GFR decline was between 0.78-0.81 ml/min

• The results overall are promising for Tolvaptan particularly if it can delay ESRD by a few years to allow time for pre-emptive transplant but concerns still remain regarding patient selection, tolerance, and the haemodynamic drop in GFR mediated by the drug.

Transcripts of the tweetchats, and curated versions as storify are available from the NephJC website.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC on twitter, liking @NephJC on facebook, signing up for the mailing list, or just visit the webpage at NephJC.com.