Regional Expert Opinion on Tolvaptan Therapy for ADPKD: Bridging Gaps in the GCC and MENA Regions

Autosomal Dominant Polycystic Kidney Disease (ADPKD) constitutes one of the most common hereditary renal disorders, characterized by progressive cystic enlargement and a subsequent decline in renal function. Although the condition presents a significant health burden in regions with high rates of consanguinity, such as the Gulf Cooperation Council (GCC) and the Middle East and North Africa (MENA), comprehensive regional data on its prevalence, diagnosis and management remain limited. Tolvaptan, a selective antagonist of the vasopressin V2 receptor, is presently the sole disease-modifying therapy approved for decelerating the progression of ADPKD. This review is based on the synthesis of current literature amalgamated with the opinions of nephrologists (from the Kingdom of Saudi Arabia, Kuwait, Oman, Bahrain and the United Arab Emirates) convened to develop guidance on the utilization of Tolvaptan in ADPKD across the GCC/MENA region. The panel underscored the significance of establishing national and regional registries, deploying standardized imaging and diagnostic protocols, expanding access to genetic testing and counseling and ensuring the safe administration of Tolvaptan during Ramadan fasting. This review aims to bridge the gap between evidence and clinical practice, providing a structured framework to guide clinicians, facilitate early diagnosis and enhance therapeutic approaches for ADPKD patients throughout the GCC and MENA regions.