POS-347 PREVALENCE OF POLYCYSTIC KIDNEY DISEASE IN THE MID WEST OF IRELAND AND CANDIDACY FOR TOLVAPTAN THERAPY

Abstract

Introduction: Tolvaptan is a vasopressin V2-receptor antagonist that inhibits cyst growth and slows the decline of kidney function in polycystic kidney disease (PCKD) TEMPO 3:4 and REPRISE Trials showed that tolvaptan slows the decline in renal function and increase in kidney size We aim to study the prevalence of polycystic kidney disease in the Mid-West region of Ireland and their candidacy for tolvaptan therapy Methods: A cross-sectional study was performed across the Mid-West for year ending 2019 to identify patients with polycystic kidney disease who attend the Renal Clinic by using the Renal Database in University Hospital Limerick Suitability for tolvaptan therapy was determined using EDTA criteria Results: 147 patients with PCKD were identified in the Mid West;mean age 55 (17-92), 47 6% male and including 52 patients with end-stage kidney disease;26 (50%) on haemodialysis, 2 (3 8%) on peritoneal dialysis and 24 (46 2%) with kidney transplants There are 95 patients with chronic kidney disease (CKD), of whom 77 had blood test performed in 2019 Among these 77 patients, 24 (31 2%) have Stage 1, 26 (33 8%) have Stage 2, 11 (14 3%) have Stage 3a, 4 (5 2%) have Stage 3b, 8 (10 4%) have Stage 4 and 4 (5 2%) have Stage 5 CKD Rapid progressors were defined as a decline in eGFR by ≥ 2 5ml/min/1 73m2yearly over 5 years, or ≥ 5ml/min/1 73m2over one year;43/77 (55 8%) rapid progressors were identified of whom 29 (67 4%) have CKD 2-3b Of these 29 patients, 19 have Stage 2, 7 have stage 3a and 3 have stage 3b CKD 23 patients with prior imaging had kidney sizes ≥17cm, 11/23 (47 8%) have CKD Stage 2 (8/11), Stage 3a (3/11) As per EDTA criteria for tolvaptan therapy including age ≤50, CKD Stages 1-3a but that CKD stage must be interpreted in conjunction with age, rapid progression status, and kidneys size >16 5cm;there are 21 patients who are eligible for treatment Conclusions: Tolvaptan therapy should be considered in 21 of 147 eligible patients identified to slow their rate of progression of CKD This abstract was also submitted for the Irish Society of Nephrology Meeting Spring 2020 which was cancelled due to Covid-19 No conflict of interest