Abstract
The vasopressin V2-receptor antagonist tolvaptan has been approved in multiple countries to slow kidney function decline in patients at risk of rapidly progressing autosomal dominant polycystic kidney disease (ADPKD). The efficacy, side effects, and risks associated with tolvaptan are described in detail in the accompanying article.2 A question that has arisen in our clinical practice is whether the potential benefit of tolvaptan in delaying the progression of ADPKD outweighs the daily impact of increased aquaresis and the risk of hepatotoxicity.
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