{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T11:52:17Z","timestamp":1778586737540,"version":"3.51.4"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tolvaptan is the only disease-modifying treatment approved to slow kidney disease progression in autosomal dominant polycystic kidney disease (ADPKD). Data on tolvaptan in ADPKD outside of clinical trials are limited, usually deal with short-term observations and are characterized by a drop-out rate of 21%\u201356%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective, observational, multicenter study enrolling 122 Italian patients with ADPKD and rapid progressive renal disease, we evaluated the tolerability and side effects of tolvaptan treatment in a real-life setting. A personalized treatment strategy, based on an accurate patient selection and a strict clinical and laboratory monitoring, was applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 34.0 (interquartile range 17.3; \u201346.5) months the overall adherence on tolvaptan was 82.0%. Permanent withdrawal was reported in 22\/122 patients (18.0%) after a mean of 34.4\u00a0\u00b1\u00a018.0 months; the main reasons for drug permanent withdrawal were onset of kidney failure in 7\/122 (5.7%), poor tolerance to aquaresis in 4\/122 (3.3%), family planning in 3\/122 (2.5%) and liver function test elevation in 2\/122 patients (1.6%). Temporary discontinuation was observed in 35\/122 patients (28.7%) and in most cases it was not related to drug side effects. In order to evaluate tolvaptan eligibility, historic estimated glomerular filtration rate decline was the most inclusive criteria (92.9%) when compared with Mayo Imaging Classification (89.7%) and Predicting Renal Outcome in Polycystic Kidney Disease (PROPKD) Score (22.6%)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This real-life study confirms the feasibility, safety, and tolerability of tolvaptan treatment. In order to overcome the challenges of tolvaptan treatment, our experience suggests that a dedicated PKD team may play a key role in implementing strategies focused to reduce drop-out and achieve treatment success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf156","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T12:40:17Z","timestamp":1747744817000},"source":"Crossref","is-referenced-by-count":1,"title":["Tolvaptan in Autosomal Dominant Polycystic Kidney Disease (ADPKD): a multicenter real life Italian experience"],"prefix":"10.1093","volume":"18","author":[{"given":"Laura","family":"Econimo","sequence":"first","affiliation":[{"name":"Radiological Sciences, and Public Health, University of Brescia \u2013 ASST Spedali Civili of Brescia Nephrology Unit, Department of Medical and Surgical Specialties, , Brescia,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3950-3777","authenticated-orcid":false,"given":"Diego","family":"Toso","sequence":"additional","affiliation":[{"name":"Radiological Sciences, and Public Health, University of Brescia \u2013 ASST Spedali Civili of Brescia Nephrology Unit, Department of Medical and Surgical Specialties, , Brescia,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovambattista","family":"Capasso","sequence":"additional","affiliation":[{"name":"Institute of Molecular Biology and Genetics Biogem, , Ariano Irpino ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Guarneri","sequence":"additional","affiliation":[{"name":"University Hospital Policlinic Paolo Giaccone Nephrology and Dialysis Unit, , Palermo ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7199-2954","authenticated-orcid":false,"given":"Silvia","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Policlinico Umberto I Hospital, Sapienza University of Rome Department of Translational and Precision Medicine, , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Rigato","sequence":"additional","affiliation":[{"name":"UOC Nephrology , Dialysis and Kidney transplantation \u2013 Ospedale S. 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