Author’s Reply to Correspondence: “Effect of Tolvaptan Treatment on Acid?Base Homeostasis in ADPKD Patients”

摘要

We thank Matteo Bargagli and his colleagues for their interest in our study and suggestion to investigate the urinary citrate excretion as a more sensitive measure of change in acidLbase regulation than plasma bicarbon- ate. In their study, they describe urinary citrate excre- tiontobehigherandnetrenalacidexcretiontobelower inADPKDpatientsusingtolvaptancomparedtoADPKD patients without tolvaptan. 1 Direct comparison of re- sults is hampered by the fact that both studies have not measured the entire acidLbase profile. We did not measure urinary citrate and net renal acid excretion, whichwouldhavebeenvaluableadditions,andBargagli and colleagues did not measure plasma pH, bicarbonate, and pCO 2 . However, results of these 2 studies are consistent in their rejection of our primary hypothesis. Tolvaptan does not seem to induce an increase in bi- carbonate reabsorption in the investigated patients.