{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:59:44Z","timestamp":1790132384434,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Venous thromboembolism (VTE) has increasingly been reported in autosomal dominant polycystic kidney disease (ADPKD), although the mechanisms underlying this association remain incompletely understood. Whether tolvaptan exposure influences VTE risk in ADPKD has not been well studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study using the TriNetX Global Collaborative Network, including adults with ADPKD (ICD\u201010\u2010CM Q61.2) from 2000 to 2025. Patients with inherited thrombophilia or prothrombin G20210A mutation were excluded. Propensity score matching (1:1) was conducted across 24 covariates to balance demographics, comorbidities, medications, and laboratory data. Exposure was analysed as a fixed treatment variable defined at cohort entry. Primary outcomes were VTE incidence, all\u2010cause mortality, and use of antithrombotic medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 39\u2009180 adults with ADPKD, 1338 received tolvaptan therapy, whereas 37\u2009362 were without tolvaptan. After 1:1 propensity score matching, 1333 matched pairs were analysed. Tolvaptan exposure was associated with lower risks of VTE (2.1% vs. 3.9%; RR 0.538, 95% CI 0.342\u20130.847;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) and all\u2010cause mortality (1.28% vs. 3.9%; RR 0.327, 95% CI 0.190\u20130.562;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Lower utilisation of warfarin, aspirin, DOAC, heparin, or enoxaparin was observed (14.8% vs. 21.4%; RR 0.689, 95% CI 0.572\u20130.830;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Subgroup analyses demonstrated generally consistent directional associations across several demographic categories, although some subgroup analyses were limited by low event counts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large propensity\u2010matched real\u2010world cohort, tolvaptan exposure was associated with lower risks of VTE and mortality among patients with ADPKD. Given the retrospective observational design and the possibility of residual confounding, these findings should be interpreted as associative and hypothesis\u2010generating rather than causal. Further prospective studies incorporating imaging\u2010based measures of disease severity are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70280","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:35:37Z","timestamp":1789436137000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Tolvaptan Exposure and Venous Thromboembolism Risk in\n                    <scp>ADPKD<\/scp>\n                    : A Real\u2010World Propensity\u2010Matched\n                    <scp>EHR<\/scp>\n                    Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5473-6594","authenticated-orcid":false,"given":"To\u2010Pang","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism Show Chwan Memorial Hospital  Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6119-0587","authenticated-orcid":false,"given":"Shang\u2010Feng","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, College of Medicine National Chung Hsing University  Taichung Taiwan"},{"name":"Division of Clinical Informatics, Department of Digital Medicine Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.128"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2009020162"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNH.0b013e3283262ab0"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)80051-5"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60601-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.59"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60907-2"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.2852"},{"key":"e_1_2_11_10_1","first-page":"332","article-title":"Compression of the Inferior Vena Cava by Right Renal Cysts: An Unusual Cause of IVC and\/or Iliofemoral Thrombosis With Pulmonary Embolism in Autosomal Dominant Polycystic Kidney Disease","volume":"49","author":"O'Sullivan D. A.","year":"1998","journal-title":"Clinical Nephrology"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/21010811"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.49.3748"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0036933014567050"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.43.209"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2011.01237.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03530411"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205511"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1710030"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.06.028"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/abhs.abhs_43_23"},{"key":"e_1_2_11_21_1","article-title":"Cyclically Bleeding Trocar\u2010Site Endometrioma Without Known History of Endometriosis: Case Report and Literature Review","volume":"2022","author":"Rahman N. A.","year":"2022","journal-title":"Journal of Surgical Case Reports"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.10.027"},{"key":"e_1_2_11_23_1","article-title":"Pulmonary Embolism in Autosomal Dominant Polycystic Kidney Patient Induced by Inferior Vena Cava Mechanical Compression","volume":"8","author":"Basheer M.","year":"2021","journal-title":"European Journal of Case Reports in Internal Medicine"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2007.02450.x"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-015-1311-6"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70280","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.70280","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70280","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:03:44Z","timestamp":1790129024000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/nep.70280"],"URL":"https:\/\/doi.org\/10.1111\/nep.70280","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70280"}}