A Case Report of Tolvaptan Therapy for ADPKD Patients With COVID-19. The Need for Appropriate Counselling for Temporary Drug Discontinuation.

Irene Capelli, Francesca Iacovella, Laura Ghedini, Valeria Aiello, Angelodaniele Napoletano, Lorenzo Marconi, Pierluigi Viale, Marco Masina, Gaetano LA Manna

In vivo (Athens, Greece) 2022 Jul-Aug

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Patients with autosomal dominant polycystic kidney disease (ADPKD) may require specific therapy with vasopressin receptor antagonists to slow the progression of renal disease. Because of its mechanism of action, the most common side effects are polyuria, nocturia, and polydipsia. Elevations of liver enzyme levels can also occur during treatment with Tolvaptan. Temporary drug withdrawal may be indicated if the patient is unable to hydrate adequately or if there are concomitant causes of dehydration, including major infectious events. During the Coronavirus Disease 2019 (COVID-19) pandemic, this should be considered in the management of patients on Tolvaptan therapy. We present the clinical case of a 51-year-old male with severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) infection and ADPKD receiving Tolvaptan therapy with particular reference to the medical management of the patient during the infectious event. The patient was instructed to discontinue promptly Tolvaptan as soon as symptoms appeared. He was treated with forced hydration and symptomatic therapy. Nevertheless, a transient elevation of liver enzyme levels was detected. The timely discontinuation of Tolvaptan therapy avoided the risk of potential hepatotoxicity in a condition of known susceptibility. Tolvaptan therapy of patients with ADPKD is safe even during SARS-CoV-2 infection. There is need for appropriate and prompt patient counseling to avoid potentially adverse side effects. Copyright © 2022, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Citation

Irene Capelli, Francesca Iacovella, Laura Ghedini, Valeria Aiello, Angelodaniele Napoletano, Lorenzo Marconi, Pierluigi Viale, Marco Masina, Gaetano LA Manna. A Case Report of Tolvaptan Therapy for ADPKD Patients With COVID-19. The Need for Appropriate Counselling for Temporary Drug Discontinuation. In vivo (Athens, Greece). 2022 Jul-Aug;36(4):1994-1997