title: Polyuria due to vasopressin V2 receptor antagonism is not associated with increased ureter diameter in ADPKD patients.
abstract: BACKGROUND
  Tolvaptan, a vasopressin V2 receptor antagonist, has been shown to reduce the rates of growth in total kidney volume (TKV) and renal function loss in ADPKD patients, but also leads to polyuria because of its aquaretic effect. Prolonged polyuria can result in ureter dilatation with consequently renal function loss. Therefore, we aimed to investigate the effect of tolvaptan-induced polyuria on ureter diameter in ADPKD patients.
  
  
  METHODS
  70 ADPKD patients were included (51 were randomized to tolvaptan and 19 to placebo). At baseline and after 3 years of treatment renal function was measured (mGFR) and MRI was performed to measure TKV and ureter diameter at the levels of renal pelvis and fifth lumbar vertebral body (L5).
  
  
  RESULTS
  In these patients [65.7 % male, age 41 ± 9 years, mGFR 74 ± 27 mL/min/1.73 m2and TKV 1.92 (1.27-2.67) L], no differences were found between tolvaptan and placebo-treated patients in 24-h urine volume at baseline (2.5 vs. 2.5 L, p = 0.8), nor in ureter diameter at renal pelvis and L5 (4.0 vs. 4.2 mm, p = 0.4 and 3.0 vs. 3.1 mm, p = 0.3). After 3 years of treatment 24-h urine volume was higher in tolvaptan-treated patients when compared to placebo (4.7 vs. 2.3 L, p < 0.001), but no differences were found in ureter diameter between both groups (renal pelvis: 4.2 vs. 4.4 mm, p = 0.4 and L5: 3.1 vs. 3.3 mm, p = 0.4).
  
  
  CONCLUSIONS
  Tolvaptan-induced polyuria did not lead to an increase in ureter diameter, suggesting that tolvaptan is a safe therapy from a urological point of view.
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. N.F.Casteleijn@umcg.nl.|Expertise Center for Polycystic Kidney Disease, Groningen, The Netherlands. N.F.Casteleijn@umcg.nl.
authors.forename: Niek F
authors.initials: NF
authors.lastname: Casteleijn
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Expertise Center for Polycystic Kidney Disease, Groningen, The Netherlands.
authors.forename: A Lianne
authors.initials: AL
authors.lastname: Messchendorp
authors.affiliation: Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Kyong T
authors.initials: KT
authors.lastname: Bae
authors.affiliation: Department of Urology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Higashihara
authors.affiliation: Expertise Center for Polycystic Kidney Disease, Groningen, The Netherlands.|Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Kappert
authors.affiliation: Department of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Vicente
authors.initials: V
authors.lastname: Torres
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Expertise Center for Polycystic Kidney Disease, Groningen, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Meijer
authors.affiliation: Expertise Center for Polycystic Kidney Disease, Groningen, The Netherlands.|Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Leliveld
mesh_terms: D000328:Adult; D065092:Antidiuretic Hormone Receptor Antagonists / Q000009:adverse effects*; D001552:Benzazepines / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016891:Polycystic Kidney, Autosomal Dominant / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D011141:Polyuria / Q000139:chemically induced* / Q000503:physiopathology; D017483:Receptors, Vasopressin / Q000187:drug effects* / Q000378:metabolism; D012307:Risk Factors; D013997:Time Factors; D000077602:Tolvaptan; D016896:Treatment Outcome; D014513:Ureter / Q000000981:diagnostic imaging / Q000187:drug effects*; D014563:Urodynamics / Q000187:drug effects
chemical_list: C585768:AVPR2 protein, human; D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D017483:Receptors, Vasopressin; D000077602:Tolvaptan
keywords: Autosomal dominant polycystic kidney disease; Polyuria; Tolvaptan; Ureter