Tolvaptan for intractable edema in a patient with diabetic nephropathy syndrome
Diabetic nephropathy syndrome(DNS)is a secondary nephrotic syndrome mediated by nonimmune factors.Such patients become more dependent on diuretics for the treatment of their induced edema due to ineffectiveness of the hormone as the onset of their disease is nonimmune mediated.The novel diuretic tolvaptan,a selective vasopressin V2 receptor antagonist independent of albumin,is currently used primarily to reduce edema caused by cirrhosis,heart failure,and abnormal antidiuretic hormone secretion,and may also be used as an adjunctive therapy in autosomal dominant polycystic kidney disease,but is used less frequently in patients with DNS.In this article,we discuss the effectiveness,safety,and future prospects of tolvaptan in the treatment of patients with DNS by sharing the experience of a DNS patient with edema treated with tolvaptan.
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