I realize that the TEMPO study suggests tolvaptan be used in patients with intact renal function (that is who they enrolled) but have you been using it for later stage CKD as well?
Dr. JS
During the TEMPO trial patients with CKD function 1,2 and 3 were enrolled and found to benefit from tolvaptan, that is less kidney enlargment and less deterioration of renal function(as compared to placebo). There were no stage 4 patients, therefore the benefit here is not demonstrated but is presently being tested in an ongoing study (REPRISE).