Can tolvaptan treat polycystic kidney disease?

Patient's question:

I am consulting for a colleague's father, who has been suffering from polycystic kidney disease for over three years. It is said that tolvaptan is very effective in treating polycystic kidney disease, but I haven't received a definite answer. I am also hesitant to let him take it. Is tolvaptan really effective in treating polycystic kidney disease?

Doctor's answer:

For ADPKD patients with poor renal function, tolvaptan has less interference on urine volume, urine osmolality, and TKV, but it significantly interferes with the complete clearance of free water. In this regard, researchers believe that for ADPKD patients with poor renal function, the interference of tolvaptan on urine volume, urine osmolality, and TKV is not due to reduced drug sensitivity, but may be due to the progressively smaller functional renal mass and structural renal dysfunction.

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