How to Protect Your Liver During Polycystic Kidney Disease Treatment

One class of medication to treat polycystic kidney disease (PKD) is called vasopressin 2 receptor (V2R) antagonists. V2R antagonists aim to help reduce the formation of cysts on the kidneys. This may help slow the decline of kidney function over time.

V2R antagonists may be very beneficial for people with PKD, but one risk is that they may have harmful side effects to the liver in some people.  It’s important to know that this isn’t very common, and your care team will help you monitor and manage your liver health.

How will my care team monitor my liver health while taking V2R antagonists?

Before  starting a V2R antagonist, you will likely undergo regular blood tests known as a hepatic panel. These blood laboratory tests  help check your liver function. 

If you experience very abnormal results from these liver function tests, you may need to stop the medication or may not be cleared to take the medication to begin with. 

Can I take V2R antagonists if I have other liver conditions?

It may not be safe for you to take V2R antagonists if you have another liver condition. Examples include:

• Hepatitis B

• Hepatitis C

• Liver cancer

• Liver disease

• Cirrhosis

Even if you have these conditions, you may still be eligible to trial the medication with careful monitoring. 

What are healthy habits to help protect the liver while taking V2R antagonists?

Your care team may recommend a number of lifestyle changes to help protect your liver as much as possible while treating PKD. Liver-protecting habits include:

• Avoiding alcohol, which is generally toxic to the liver

• Avoiding other illicit substance use

• Following dosing guidelines for or avoiding acetaminophen altogether  to reduce the risk of liver damage

How do I know if V2R antagonists are right for me?

All medications come with some degree of risks, and your healthcare provider generally prescribes them if they believe the benefits outweigh the risks. 

For most people, the risk of liver disease from V2R antagonists is relatively low. For people with more severe polycystic kidney disease, this small risk may be worth it in order to delay or prevent the need for dialysis or a kidney transplant. Your healthcare provider will usually have a discussion with you about the risks versus benefits based on your specific health factors.

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Written by:

Lauren Smith, MA

Lauren Smith, MA, has worked in health journalism since 2017. Before joining GoodRx, she was the senior health editor and writer for HealthiNation.

Reviewed by:

Alexandra Schwarz, MD

Alexandra Schwarz, MD, is a board-eligible sleep medicine physician and a board-certified family medicine physician. She is a member of both the AASM and the ABFM.

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