Tolvaptan for autosomal dominant polycystic kidney disease: Real-world insights from a propensity score weighted retrospective cohort study

Tolvaptan was not associated with a statistically significant slowing of kidney function decline. Point estimates suggest a modest potential benefit which is attenuated when compared to controlled trials. Treatment discontinuation substantially limited treatment exposure. Further real-world evidence is required to clarify tolvaptan's true effectiveness outside controlled trial settings.