Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11500-11507
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11500
Tolvaptan ameliorated kidney function for one elderly autosomal dominant polycystic kidney disease patient: A case report
Li Zhou, Yan Tian, Liang Ma, Wen-Ge Li
Li Zhou, Wen-Ge Li, Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China
Yan Tian, Department of Ultrasound Medicine, China-Japan Friendship Hospital, Beijing 100029, China
Liang Ma, Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing 100029, China
Author contributions: Zhou L performed diagnosis and therapy administration on the patient; Tian Y and Ma L collected the clinical information, analyzed and interpreted the clinical data; Zhou L drafted the manuscript; Li W reviewed the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was signed and obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that there is no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Ge Li, MD, Director, Department of Nephrology, China-Japan Friendship Hospital, No. 2 East Yinghuayuan Street, Chaoyang District, Beijing 100029, China. wenge_lee2002@126.com
Received: May 13, 2022
Peer-review started: May 13, 2022
First decision: August 4, 2022
Revised: August 9, 2022
Accepted: October 9, 2022
Article in press: October 9, 2022
Published online: November 6, 2022
Abstract
BACKGROUND

Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts within the kidneys. Disease progress of some patients often occurs at the early stage. Thus, managing and controlling disease progress is important to slow the kidney function decline especially for the patient with other disorders.

CASE SUMMARY

One 80-year-old male autosomal dominant polycystic kidney disease (ADPKD) patient with chronic kidney disease and other clinical disorders was treated with tolvaptan and edoxaban. Estimated glomerular filtration rate, creatinine and uric acid were monitored during the treatment. In addition, the whole exome sequencing was performed to screen ADPKD genetic variants. The kidney function decline was prevented after using tolvaptan and edoxaban treatment and in the meantime, a venous thromboembolism was removed and leg and pedal edema were alleviated. One mutation c.10102G>A /p.D3368N in the PKD1 gene was identified.

CONCLUSION

Tolvaptan combined with edoxaban administration could delay kidney function decline and eliminate the edema caused by the thromboembolism.

Keywords: Chronic kidney disease, Autosomal dominant polycystic kidney disease, Deep vein thrombosis, Tolvaptan, Case report

Core Tip: Autosomal dominant polycystic kidney disease is a genetic and heritable kidney disease. It appears with cyst formation and growth, kidney enlargement and eventually leads to end stage renal disease. Some patients with severe polycystic kidney disease and end stage kidney disease have been treated with nephrectomy and early dialysis therapy, however, the life quality of these autosomal dominant polycystic kidney disease (ADPKD) patients declines due to the above treatment. In this case report, tolvaptan combined with edoxaban administration improved kidney function for one elderly ADPKD patient while avoiding the decreased life quality from nephrectomy or dialysis therapy.