The safety and efficacy of tolvaptan in the treatment of patients with autosomal dominant polycystic kidney disease: A systematic review and meta-analysis

• Published in: Nefrología 2023-11, Vol.43 (6), p.731-741
• Main Authors: Li, Xuanwei, Li, Wenlai, Li, Yue, Dong, Chuanjiang, Zhu, Ping
• Format: Article
• Language: English
• Subjects: ADPKD (autosomal dominant polycystic kidney disease); Antidiuretic Hormone Receptor Antagonists - adverse effects; Antidiuretic Hormone Receptor Antagonists - therapeutic use; Benzazepines - adverse effects; Benzazepines - therapeutic use; Disease Progression; eGFR (estimated glomerular filtration rate); eGFR (tasa de filtración glomerular estimada); ERPAD (enfermedad renal poliquística autosómica dominante); Glomerular Filtration Rate - drug effects; Humans; Polycystic Kidney, Autosomal Dominant - complications; Polycystic Kidney, Autosomal Dominant - drug therapy; Randomized Controlled Trials as Topic; TKV (total kidney volume); Tolvaptan; Tolvaptan - therapeutic use; Treatment Outcome; VRT (volumen renal total)
• ISSN: 2013-2514; 2013-2514
• DOI: 10.1016/j.nefroe.2023.04.002

The irreversible progression of autosomal dominant polycystic kidney disease (ADPKD) to end-stage renal disease (ESRD) is delayed by tolvaptan. Therefore, we aim to systematically estimate and evaluate the efficacy and safety of tolvaptan in the treatment of ADPKD. Two reviewers independently searched all published randomized controlled trials studies in PubMed, EMBASE, Web of Science and Cochrane databases, extracted data, assessed bias risk and rated the quality of evidence. Data were analyzed by the RevMan software. We identified 8 trials including 2135 patients. Both of the decline of estimated glomerular filtration rate (eGFR) [MD=1.89, 95% CI (0.74, 3.04), P=0.001] and total kidney volume (TKV) [MD=−3.32, 95% CI (−4.57, −2.07), P