Abstract：
BACKGROUND: 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.
METHODS: 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.
CONCLUSIONS: 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.
METHODS: 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.
CONCLUSIONS: 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.
摘要：
背景：常染色体显性多囊肾病（ADPKD）患者可能需要使用加压素受体拮抗剂进行特异性治疗以减缓肾脏疾病的进展。由于其作用机制,最常见的副作用是多尿，夜尿症,和多饮。在用托伐普坦治疗期间也可发生肝酶水平的升高。如果患者不能充分水合或合并有脱水原因，则可能需要暂时停药。包括重大传染病。在2019年冠状病毒病(COVID-19)大流行期间，在托伐普坦治疗患者的治疗中应考虑这一点.
方法：我们介绍了一名患有严重急性呼吸道综合征冠状病毒-2（SARS-CoV-2）感染和ADPKD的51岁男性的临床病例，特别是在感染事件期间对患者的医疗管理。一旦症状出现，患者被指示立即停止托伐普坦。他接受了强制水合和对症治疗。然而，检测到肝脏酶水平的短暂升高。及时停止托伐普坦治疗避免了在已知易感性条件下潜在肝毒性的风险。
结论：托伐普坦治疗ADPKD患者即使在SARS-CoV-2感染期间也是安全的。需要适当和及时的患者咨询以避免潜在的不良副作用。
方法：我们介绍了一名患有严重急性呼吸道综合征冠状病毒-2（SARS-CoV-2）感染和ADPKD的51岁男性的临床病例，特别是在感染事件期间对患者的医疗管理。一旦症状出现，患者被指示立即停止托伐普坦。他接受了强制水合和对症治疗。然而，检测到肝脏酶水平的短暂升高。及时停止托伐普坦治疗避免了在已知易感性条件下潜在肝毒性的风险。
结论：托伐普坦治疗ADPKD患者即使在SARS-CoV-2感染期间也是安全的。需要适当和及时的患者咨询以避免潜在的不良副作用。
