А каков механизм действия?

A urinary-concentrating defect is perhaps
the earliest clinical manifestation of ADPKD
and is often accompanied by elevated serum
vasopressin levels. The vasopressin-2 receptor
(V2R) is the major source of renal cAMP,
and cAMP is elevated in ADPKD kidneys
and cyst fluids. ADPKD cyst epithelial
cells proliferate and cysts grow in response
to cAMP, in contrast to cAMP-induced
growth inhibition of normal kidney epithelial
cells. This group of observations has led
to impressive demonstrations of cyst growth
retardation in rodent models of polycystic
kidney disease, most impressively in the
demonstration that the genetic absence of
arginine vasopressin in the Brattleboro rat
protects dramatically against cyst growth in
the Pcy rat model of polycystic kidney disease.
5 V2R inhibition may also afford independent
protection against hypertension
and progressive loss of renal function.

The suppression of vasopressin release by means of high water intake, genetic elimination of vasopressin, and vasopressin V2-receptor blockade all reduce the cyst burden and protect kidney function

PCK rats, encouraged to drink enough water to reduce urine osmolality below that of plasma, show a marked reduction in renal enlargement with preservation of renal function.

highly informed patients will undoubtedly ask: How much water should I drink now? Patients have already figured out that if extra water decreases vasopressin and cAMP levels, then why isn’t plain old water a useful therapy? No one can give an informed, definitive answer to that question, but common sense leads me to think that sufficient water should be drunk to keep plasma vasopressin levels near a point that renders urine osmolality equal to or modestly lower than that of plasma. It would be impossible to meet the mark of the Brattleboro rat unless patients drank approximately 20 L of water daily. In the short term, a more moderate target would seem to be in order. To know for certain how much of the “water cure” is prudent therapy, a carefully controlled clinical trial seems justified.

Кардиоваскулярный и почечный комитет FDA пока НЕ одобрили использование толваптана для лечения поликистоза (6 голосов - за, 9 - против).

Печалька. А почему интересно не одобрили?

Если я правильно понял Vasiliy, то из-за названия фирмы. Названия-то надо поприличней выбирать!

Будем ждать 1 сентября.

the FDA requested Otsuka provide additional data to further evaluate the efficacy and safety of tolvaptan in patients with ADPKD.

This is not the end of finding treatments, but the beginning.

. Предполагают, что пить надо больше:)

Сколько надо пить?

20 литров в день должно быть достаточно