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NDT Plus Advance Access published online on January 16, 2009
NDT Plus, doi:10.1093/ndtplus/sfn210
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Rapamycin reduces kidney volume and delays the loss of renal function in a patient with autosomal-dominant polycystic kidney disease

Ramón Peces1, Carlos Peces2, Virginia Pérez-Dueñas3, Emilio Cuesta-López3, Sebastián Azorín1 and Rafael Selgas1

1 Servicio de Nefrología, Hospital Universitario La Paz, Madrid
2 Area de Tecnología de la Información, SESCAM, Toledo
3 Servicio de Radiología, Hospital Universitario La Paz, Madrid, Instituto Reina Sofía de Investigación Nefrológica, Spain

Correspondence: Ramón Peces, Servicio de Nefrología, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain. Tel: +34-917277151; Fax: +34-917277382; E-mail: cpeces{at}varnet.com


  Abstract

This is the first report of a case of a reduction in kidney volume and preservation of renal function in a patient with autosomal-dominant polycystic kidney disease (ADPKD) receiving rapamycin. A 42-year-old man with ADPKD and a severe persistent bleeding from his solitary left kidney was successfully treated with tranexamic acid (TXA). He also received low-dose rapamycin for 8 months, and this was associated with a 23.5% reduction in kidney volume, improvement and stabilization of renal function, and normalization of haemoglobin levels. When treatment with rapamycin was interrupted, renal function deteriorated within an 8-month period and haemodialysis (HD) became necessary. Kidney volume increased at once, and life-threatening bleeding prompted a nephrectomy 4 months after the onset of HD. These data suggest that the reduction in kidney volume and preservation of renal function with rapamycin could be the result of the antiangiogenic, antiproliferative effects of rapamycin.

Key Words: ADPKD • mTOR • rapamycin • renal function • volume change

Received for publication August 27, 2008. Accepted for publication December 22, 2008.


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