ArticleClinical nephrology2025
Real-world evidence for using urine osmolality as a practical tool in tolvaptan dose optimization in patients with ADPKD.
Article in Clinical nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of this prospective single-center study was to evaluate the role of morning urine and 24-hour urine osmolality as biomarkers for guiding individualized dosing of tolvaptan in adults with rapidly progressive autosomal dominant polycystic kidney disease (ADPKD), with the aim of minimizing treatment discontinuations and adverse events. MATERIALS AND
methods24 patients (13 men, 11 women; aged 21 - 54 years) received tolvaptan for 7 - 50 months. Dosing was titrated based on tolerability and achievement of urine osmolality ≤ 250 mOsm/kg, measured by freezing point osmometry in both morning spot and 24-hour urine samples.
results16 patients (66.7%) remained on 45/15 mg, 7 (29%) required 60/30 mg, and 1 patient (4%) escalated to 90/30 mg of tolvaptan. Morning urine osmolality decreased significantly from 404 ± 231 mOsm/kg to 153 ± 61 mOsm/kg (p < 0.001), and 24-hour urine osmolality was maintained at ≤ 250 mOsm/kg in all patients. No significant differences in osmolality were observed between the patients on 45/15 mg and 60/30 mg. Mild liver enzyme elevations occurred in 9% of 504 total measurements, with 1 patient discontinuing treatment due to a 3-fold rise in transaminases. Another patient discontinued treatment due to aquaretic side effects.
conclusionUrine osmolality is a practical and effective biomarker for guiding individualized tolvaptan titration in patients with ADPKD. This approach enabled adequate vasopressin suppression and was associated with a low discontinuation rate, supporting its use in real-world clinical practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.