#5783 REAL-LIFE USE OF TOLVAPTAN IN ADPKD: A RETROSPECTIVE ANALYSIS OF A LARGE CANADIAN COHORT

Abstract Background and Aims Tolvaptan is the first disease-modifier therapy proven to slow eGFR decline in high-risk patients with ADPKD. However, barriers its use real-life settings have not been examined. Method Single-center, retrospective study of 523 current or new ADPKD followed at Center for Innovative Management PKD Toronto, Ontario between January 1, 2016 December 30, 2018. All had clinical assessment total kidney volume measurements; those deemed be high risk based on their Mayo Clinic Imaging Class (MCIC) 1C, 1D, 1E, were offered tolvaptan preference (yes no) reasons choices recorded. Results Overall, 315/523 (60.2%) MCIC 1C-1E; however, only 96 (30%) them treated last follow-up. Among these patients, more likely a higher (61 ±27 vs. 82 ±26 ml/min/1.73 m2), CKD stages 1–2 (41% 79%), 1D-1E (69% 37%). The most common provided taking lifestyle related aquaretic effect (51%), older age ≥60 (12%), pregnancy family planning (6%). Conclusion In this real-world experience, least 60% considered progression ESKD by imaging tolvaptan; earlier well-preserved eGFR. reason refusal consider concern intolerability side-effect; strategies mitigate side-effect may help reduce barrier therapy.