Tolvaptan treatment is associated with altered mineral metabolism parameters and increased bone mineral density in ADPKD patients.

Bargagli, Matteo; Vetsch, Andri; Anderegg, Manuel A; Dhayat, Nasser A; Huynh-Do, Uyen; Faller, Nicolas; Vogt, Bruno; Ferraro, Pietro Manuel; Fuster, Daniel G (2023). Tolvaptan treatment is associated with altered mineral metabolism parameters and increased bone mineral density in ADPKD patients. Nephrology, dialysis, transplantation, 38(7), pp. 1645-1654. Oxford University Press 10.1093/ndt/gfac298

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Autosomal-dominant polycystic kidney disease (ADPKD) is characterized by a unique bone and mineral phenotype. The impact of Tolvaptan treatment on mineral metabolism and bone mineral density is unknown.


We conducted an analysis in the Bern ADPKD registry, a prospective observational cohort study. Mineral metabolism parameters were measured at baseline and every 12 months thereafter. Bone mineral density was determined by dual-energy X-ray absorptiometry at baseline and after 3 years. Multivariable mixed-effects regression models were applied to assess changes in mineral metabolism parameters and bone mineral density associated with Tolvaptan treatment.


A total of 189 participants (122 without and 67 with subsequent Tolvaptan treatment) were included in the analysis. During follow-up, Tolvaptan treatment was associated with increased bone mineral density at the femoral neck (β 0.092; 95% CI 0.001, 0.183; p = 0.047). In addition, Tolvaptan treatment was associated with higher plasma magnesium (β 0.019; 95% CI 0.001, 0.037; p = 0.037), bicarbonate (β 0.972; 95% CI 0.242, 1.702; p = 0.009) and urine pH (β 0.214; 95% CI 0.056, 0.372; p = 0.008), and lower parathyroid hormone (β -0.191; 95% CI -0.328, -0.053; p = 0.006), 1,25-(OH)2-Vitamin D3 (β -0.126; 95% CI -0.235, -0.164; p = 0.024) and fractional urinary magnesium excretion (β -0.473; 95% CI -0.622, -0.324; p < 0.001).


Chronic Tolvaptan treatment is associated with increased femoral bone mineral density and significant changes in both mineral metabolism and acid-base parameters in ADPKD patients.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension

UniBE Contributor:

Bargagli, Matteo, Anderegg, Manuel, Dhayat, Nasser, Huynh-Do, Uyen, Faller, Nicolas, Vogt, Bruno, Fuster, Daniel Guido


600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology




Oxford University Press




Pubmed Import

Date Deposited:

31 Oct 2022 08:42

Last Modified:

01 Jul 2023 00:11

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Uncontrolled Keywords:

ADPKD Tolvaptan bone mineral density mineral metabolism


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