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Tolvaptan

Tolvaptan is in clinical trials to decrease kidney cysts; it suppresses vasopressin, a cyst growth trigger. Drinking copious amounts of water, enough to exceed serum osmolality or about 3 liters/day, also suppresses vasopressin. Caffeine increases cyclicAMP, which in turn increases vasopressin.

Clinical Trial Tolvaptan

Tolvaptan"s side effects include increased thirst and increased urine output 4-5 liters per day (quarts). Individuals taking tolvaptan must keep up with this fluid loss. It has been found safe and effective in congestive heart failure and cirrhosis of the liver. TEMPO Phase II (2) the open label study, (every participant receives tolvaptan) is well underway. In the double blind study, phase III (3) some individuals receive tolvaptan others do not. Additional Tolvaptan trials have begun, including one by DaVita.

Tolvaptan Inclusion - exclusion

• PKD, no other diseases
• age 18 - 50 years of age
• no other medications other than blood pressure
• good kidney functioning - serum creatinine of 1.5 or less
• Large kidney volume greater than 1000 cc

This third phase is to determine if Tolvaptan is effective in diminishing kidney cyst growth with PKD polycystic kidney disease. For this 1000 to 3000 volunteers will be needed to complete the fast track FDA approval granted by the FDA. Tolvaptan, a vasopressin 2 blocking drug for polycystic kidney disease is useful for both ADPKD, the autosomal dominant version and ARPKD, the autosomal recessive version. Tolvaptan (Otsuka Maryland Research Institute): Tolvaptan recently received fast track designation by the Food and Drug Administration because of its promise as a treatment for PKD. Tolvaptan a vasopressin inhibitor; a V2 Receptor blocker or a V2 drug. Surrounding kidney cysts is vasopressin and cyclic AMP. This triggers kidney cysts to fill with fluid, triggering kidney cyst expansion and growth. You may be wondering what can stimulate cyclic AMP to start this process causing kidney cysts to expand, fill with fluid and to multiply in numbers? Caffeine–caffeine from chocolate, de-caf coffee, de-caf tea, black tea, green tea, white tea, coffee in all its forms and all other products containing caffeine stimulates cyclic AMP. With congestive heart failure diuretics are useful but can lead to kidney problems. OPC 41061 or OPC 31026 (Tolvaptan) reduces fluid buildup, but it works differently from diuretics. OPC 41061 impedes the action of proteins in the kidney called vasopressin V2 receptors. These molecules respond to the hormone vasopressin, which signals cells to take up water. Blocking V2 receptors prevents fluid from accumulating. In addition to keeping patients on the dry side, tolvaptan also appears to stabilize salt imbalances, or hyponatremia (low sodium). Hyponatremia is an important predictor of poor outcomes in heart failure patients. To date doctors have no drugs to treat this condition -- a fact that could hasten the arrival of tolvaptan. Common side effects from OPC 31260 (the mother drug) are dry mouth, thirst, and increased urination. Possible things researchers will be looking at with Tolvaptan:

• Diminishes cyst fluid without damaging kidneys
• Increases urine production
• Enhanced renal blood flow
• Increased glomerular filtration rate (GFR)
• Decreased renal vascular resistance
• Reduction of renal cyclic AMP (increased by caffeine intake)
• Prevention of renal enlargement
• Protection of renal function
• Inhibition of kidney cyst growth

Tolvaptan looks promising as a treatment for ADPKD, though it remains in clinical trials.

choose a TOLVAPTAN article TOLVAPTAN short term renal function effects ADPKD TOLVAPTAN new therapeutic agent PKD TOLVAPTAN rationale design of TEMPO TOLVAPTAN PKD effective treatments TOLVAPTAN effectiveness on PCK rat TOLVAPTAN Chemical Development of Tolvaptan TOLVAPTAN Inhibition of Renal Cysts TOLVAPTAN FDA grants fast track 2HIT G Germino named to NIH 2HIT G Germino contact info 2HIT areas of research 2HIT Genetics PKD p1 2HIT Genetics PKD p2 2HIT Genetics PKD p3 2HIT Mutations PKD1 in ADPKD2 cysts 2HIT PKD type 1 2HIT PKD1 developmental switch 2HIT clues to pathogenesis 2HIT loss Polycystin1 leads to ciliary dysfunction 2HIT mutation ind liver cysts supports Two-Hit Model PKD 2HIT polycystin-1 polycystin-2 2HIT inheritance stable mutation family early onset disease 2HIT advances ADPKD 2HIT lab comparison of platforms 2HIT Pax2 gene influences cystogenesis PKD 2HIT Autoproteolysis Polycystin-1, product PKD1 gene 2HIT Nanomechanics Polycystin-1 extracellular region 2HIT mutations Kidney Liver Cysts support two-hit model ANEMIA in chronic kidney disease ANEMIA in PKD ANEMIA Reversing of LVH ANEMIA lowering blood pressure ANEMIA High Salt Intake LVH ANEMIA Cardiac MRI LVH ANEMIA Vigorous BP control LVH ANEURYSM Fact Sheet ANEURYSM Unruptured PKD ANEURYSM PKD risk factor ANEURYSM carotid artery PKD ASPIRIN Cumulative intake GFR decline ASPIRIN abuse renal failure ASPIRIN adverse effects low-dose ASPIRIN abandon w/o ASVD disease ASPIRIN use with transplants BACK PAIN Ozone Effective As Surgery BACK PAIN Topical Knee Pain BACK PAIN Spinal-Stretching Device BACK PAIN Acupuncture Tops Conventional BACK PAIN Eased Tapentadol BACK PAIN Constipation Releved BACK PAIN from Meg BLOOD PRESSURE top 15 foods to avoid BLOOD PRESSURE Salt restriction BLOOD PRESSURE salt restriction ESRD BLOOD PRESSURE renin-angiotensin BLOOD PRESSURE Caffeine BP BLOOD PRESSURE early diagnosis PKD BLOOD PRESSURE PKD family BLOOD PRESSURE Folate Intake BP BLOOD PRESSURE grape jc reduce BP BLOOD PRESSURE Citrate BP BLOOD PRESSURE urinary citrate BLOOD PRESSUR care ADPKD BLOOD PRESSURE Potassium Citrate BLOOD PRESSURE Controlling PKD BP BLOOD PRESSURE Cold Weather BP BLOOD PRESSURE Renin Angiotensin BLOOD PRESSURE facts PKD BP BLOOD PRESSURE Less Sleep BP BLOOD PRESSURE ASHD death BLOOD PRESSURE Creatinine Rise ACE BLOOD PRESSURE Rigorous BP ADPKD BLOOD PRESSURE Young PKD Adults CIPRO achilles tendon DECREASE CYST GROWTH halts PKD DECREASE CYST GROWTH brochure DECREASE CYST GROWTH CKD CHRONIC PAIN PKD management CHRONIC PAIN eases opiod constipation CHRONIC PAIN Pain Management in PKD CHRONIC PAIN Managment CHRONIC PAIN Pain makes you old DEROOFING PLD 6 yr New Zealand DEROOFING PLD gas-less DEROOFING PLD gas-less abstract DEROOFING PLD Re-expansion Liver Cyst DEROOFING PLD Dr. Valente DEROOFING PLD Radiological therapy DEROOFING PLD Mini-invasive approach DEROOFING PLD Sclerotherapy DEROOFING PLD Ethanol sclerosis DEROOFING PLD Cyanoacrylate glue sclerosis DEROOFING PLD Sclerosis not definitive therapy DEROOFING PLD Liver Cysts HVOO DEROOFING PLD Serial ablation alt to transplant DEROOFING PLD Long term results DEROOFING PLD Laparoscopic fenestration simple cyst DEROOFING Laparoscopic denervation DEROOFING Laparoscopic decortication DEROOFING Minimally invasive surgically DEROOFING Laparoscopic cyst fenestration DEROOFING Laparoscopic hepatic cyst DEROOFING percutaneous sclerotherapy DEROOFING Hepatic Cysts DEROOFING Surgical PLD Management DEROOFING Ethanol Ablation DEROOFING not definitive therapy DEROOFING Glue for Sclerosis DEROOFING percutaneous sclerotherapy DONOR EXCHG chart DONOR EXCHG One Donor Sparks Five-Way Exchange DONOR EXCHG 5 receive kidney transplant DONOR EXCHG Listen to Dr. Montgomery's Lecture on donor exchange DONOR EXCHG Kidney Swaps Seen as Way To Ease Donor Shortage DONOR EXCHG Expanding kidney paired donation DONOR EXCHG Patrick's transplant DONOR EXCHG Robert Avery Montgomery MD EXERCISE reduces risk CKD EXERCISE does a CKD body good EXERCISE weight loss improves risk CKD EXERCISE protects memory in CKD EXERCISE intensity healthy volunteers hematuria EXERCISE retards nephropathy rat as efficiently food restriction EXERCISE even short term extends life expectancy EXERCISE leucine helps muscle mass CKD EXERCISE safe in PKD rat model EXERCISE PLD pain relief GENTAMYCIN HALT PKD New therapy HALT PKD trial brochure HALT PKD Physician's brochure HALT PKD trial enrolled HALT PKD renin-angiotensin LVH HALT PKD Increased Water HALT PKD New Treatments CRISP IMAGING CRISP renal blood flow marker disease severity IMAGING CRISP Renal structure in early ADPKD IMAGING CRISP Cyst Number but Not the Rate of Cystic Growth ADPKD IMAGING CRISP Abstract of Cyst Number IMAGING CRISP a new frontier in the diagnosis of PKD IMAGING CRISP Imaging Progression in ADPKD IMAGING CRISP Volume Progression in ADPKD IMAGING CRISP Approaches to Testing New Treatments IMAGING CRISP MRI Provides An Early Alert IMAGING CRISP Volume Progression in PKD IMAGING CRISP MRI Evaluation of Hepatic Cysts in Early PKD IMAGING CRISP Renal Innervation BP ADPKD IMAGING CRISP Volume Progression in Polycystic Kidney Disease IMAGING CRISP Increases in kidney volume detected within 6 months IMAGING CRISP New therapeutic prospects ADPKD IMAGING GADOLINIUM warning IMAGING GADOLINIUM FDA issues IMAGING GADOLINIUM FDA issues black box warning IMAGING GADOLINIUM nephrotoxic? KIDNEY FLOW Prone Position on Renal Function with Acute Lung Injury KIDNEY FLOW Prone Position CardiovascularRenal Function KIDNEY FLOW MRI Acute and Chronic Kidney Diseases KIDNEY FLOW Body position renal perfusion measured nuclear scintigraphy. KIDNEY FLOW Renal perfusion on hydrostatic pressure KIDNEY FLOW in utero KIDNEY FLOW Effect of Body Position Nuclear Scintigraphy KIDNEY FLOW Renin-Angiotensin System Blockade KIDNEY TOXINS medications KIDNEY TOXINS contrast media KIDNEY TOXINS chemicals KIDNEY TOXINS food KIDNEY TOXINS more on food KIDNEY TOXINS herbs KIDNEY TOXINS more on herbs KIDNEY TOXINS PKD Diet Book KIDNEY TOXINS PKD Diet iTunes LVH causes of mortality ADPKD LVH ACE inhibitors LVH hypertension BP reduction. LVH Left Ventricular Hypertrophy LVH 40 Causes LVH High salt intake LVH Drugs Reverse End-Organ LVH in PKD LVH after kidney transplantation LVH Cardiac Renal Effects NSAIDs in Chronic Kidney Disease NSAIDs prolong the bleeding NSAIDs: analgesic-associated nephropathy NSAIDs analgesic-induced kidney disease NSAIDs Analgesic Kidney Disease NSAIDs Causes of Kidney Disease? NSAIDs pain management renal or hepatic NSAIDs Harm Reduction Conf NSAIDs analgesic Kidney Disease NSAIDs Analgesic renal failure NSAIDs Cardiovascular Risk NSAIDs analgesic-associated nephropathy OGBURN acid-alkaline balance CKD OGBURN PKD child OGBURN 35% protein harm OGBURN high pro lowers GFR OSTEOPOROSIS immunosuppressive agents OSTEOPOROSIS CKD OSTEOPOROSIS Lemon egg Calcium Citrate OSTEOPOROSIS Raw Food Vegans OSTEOPOROSIS exploring a low acidic diet OSTEOPOROSIS dietary caffeine OSTEOPOROSIS Potassium citrate increases bone OSTEOPOROSIS nhibition of nanobacteria OSTEOPOROSIS potassium citrate effect on bones OSTEOPOROSIS Potassium positive effect OSTEOPOROSIS bisphosphonates spontaneous femur fx OSTEOPOROSIS Long Alendronate spontaneous femur fx OSTEOPOROSIS Long term use bisphosphonates with fractures PAIN RELIEF suggestions PAIN RELIEF laparoscopic denervation PAIN RELIEF Thoracic splanchnic nerves PAIN RELIEF surgical sympathectomy PAIN RELIEF Patient’s Manual PAIN RELIEF Pain Management PAIN RELIEF Minimally Invasive Surgery PAIN RELIEF Acute renal hepatic PAIN RELIEF Pain Management PAIN RELIEF Hepatic Cysts sclerotherapy PAIN RELIEF Glue for Sclerosis PAIN RELIEF Laparoscopic Fenestration PAIN RELIEF acute management PAIN RELIEF in PKD PAIN RELIEF Volume Progression PAIN RELIEF Glucosamine Chondroitin PKD BASICS slides PKD PKD BASICS listen to lecture PKD BASICS bone disease CKD PKD BASICS calciphylaxis PKD BASICS cipro antibiotic PKD BASICS pkd part 1 PKD BASICS pkd part 2 PKD BASICS pkd part 3 PKD BASICS Grantham PKD PKD BASICS Increase kidney vol PKD BASICS 2008 PKD BASICS part 1 PKD BASICS part 2 PKD BASICS PKD1 PKD2 mutations PKD BASICS new therapy PKD PKD BASICS PKD BASICS FAQs PKD PKD DIAGNOSIS criteria PKD PKD DIAGNOSIS ultrasound PKD PKD DIAGNOSIS diagnosis PKD PKD HEALTH Potassium Citrate improves PKD PKD HEALTH Alkalinity improves GFR PKD HEALTH Modifiable factors in PKD PKD HEALTH Water study PKD HEALTH Renal Perfusion PKD HEALTH BP Halt clinical trial PKD HEALTH Solé Recipe PKD HEALTH Modifiable factors to slow down CKD PKD HEALTH Inflammation PKD DIAGNOSIS criteria dx PKD PKD OUTCOME infancy childhood PKD OUTCOME ADPKD in Pakistan PKD OUTCOME mortality ADPKD PKD OUTCOME liver in ADPKD SCLEROTHERAPY Ethanol Ablation SCLEROTHERAPY not definitive therapy SCLEROTHERAPY Cyanoacrylate Glue SCLEROTHERAPY Laparoscopic SCLEROTHERAPY percutaneous SCLEROTHERAPY Laparoscopic denerve SCLEROTHERAPY Mini Invasive Surgery SPLANCHNIC RELIEF clinical trial SPLANCHNIC RELIEF Thoracic nerves SPLANCHNIC RELIEF Thoracic nerves SPLANCHNIC RELIEF Opioid use SPLANCHNIC RELIEF NCPB VSPL SPLANCHNIC RELIEF Study SPLANCHNIC RELIEF NCPB, VSPL SPLANCHNIC RELIEF Videothoracoscopic SURGERY PAIN fentanyl spinal anesth low abd SURGERY PAIN intrathecal opiod/epidural SURGERY PAIN thoracic epidural liver resect SURGERY PAIN Intrathecal opiods liver donors SURGERY PAIN Darvon banned TOLVAPTAN short term renal function effects ADPKD TOLVAPTAN new therapeutic agent PKD TOLVAPTAN rationale design of TEMPO TOLVAPTAN PKD effective treatments TOLVAPTAN effectiveness on PCK rat TOLVAPTAN Chemical Development of Tolvaptan TOLVAPTAN Inhibition of Renal Cysts TOLVAPTAN FDA grants fast track TRANSPLANT Prophylaxis antiviral reduces CMV TRANSPLANT FDA extends use CMV drug after Tx TRANSPLANT Antiviral prophylaxes reduces CMV risk TRANSPLANT Scotland Man successful once rejected TRANSPLANT Los Angeles Mom Dual Organ Transplant TRANSPLANT Pioneering surgery on girl, 12, reverses heart transplant TRANSPLANT Simultaneous Renal Transplantation Native Nephrectomy TRANSPLANT Bone Loss in Patients Long-Term Immunosuppression DONOR EXCHG chart TX DONOR EXCHG One Donor Sparks Five-Way TX DONOR EXCHG 5 receive kidneys in ransplant TX DONOR EXCHG Listen to Dr. Montgomery's Lecture on donor exchange TX DONOR EXCHG Kidney Swaps Seen as Way To Ease Donor Shortage TX DONOR EXCHG Expanding kidney paired donation TX DONOR EXCHG Patrick's transplant DONOR EXCHG Robert Avery Montgomery MD TRIAL STAT6 a possible Rx TRIAL lonidamine TRIAL tolvaptan TRIAL HALT therapeutic prospects ADPKD TRIAL HALT brochure HALT Physician's brochure TRIAL HALT enrolled first participant 2006 TRIAL HALT Renal vol renin-angiotensin-aldosterone ADPKD TRIAL WATER Increased Water IntakeADPKDt TRIAL CRISP MRI renal blood flow marker disease severity TRIAL CRISP Renal structure in early ADPKD TRIAL CRISP Cyst Number but Not the Rate of Cystic Growth ADPKD TRIAL CRISP Abstract of Cyst Number TRIAL CRISP a new frontier in the diagnosis of PKD TRIAL CRISP Imaging Progression in ADPKD TRIAL CRISP Volume Progression in ADPKD TRIAL CRISP MRI Provides An Early Alert TRIAL Volume Progression in PKD TRIAL CRISP MRI Evaluation of Hepatic Cysts in Early PKD TRIAL CRISP Renal Innervation BP ADPKD TRIAL CRISP Volume Progression in Polycystic Kidney Disease TRIAL CRISP Increases in kidney volume detected within 6 months TRIAL CRISP New therapeutic prospects ADPKD TYLENOL acute liver failure TYLENOL hepatotoxicity in rats. TYLENOL Elderly Patients TYLENOL elderly kidney function TYLENOL acetaminophen TYLENOL acute liver failure TYLENOL increasing liver failure TYLENOL Leading Cause Liver Failure TYLENOL FDA Report Warning TYLENOL Black Box Warning by FDA TYLENOL FDA requires new labels TYLENOL Aspirin Risk Kidney Failure TYLENOL aspirin chronic kidney disease TYLENOL Mulungai may combat toxicity TYLENOL liver toxic

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We are  sharing our experiences with PLD Diet, an adjunct diet to consider  trying to complement a physician's prescribed medical therapy. Think  about testing this only with your doctor's prior knowledge, who can  adjust it, according to your own uniqueness by adding to your current  treatment.

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