How V2R Antagonists Help Treat Polycystic Kidney Disease in Black Americans

One treatment option for polycystic kidney disease (PKD) is vasopressin 2 receptor (V2R) antagonists. Not everyone is the right fit for V2R antagonists. For those who are a good candidate, these medications may help slow the progression of PKD and slow the decline of kidney function.

How do V2R antagonists work to treat polycystic kidney disease?

Vasopressin is a hormone that your brain secretes. In people with PKD, this hormone tends to be at very high levels. The hormone may plan a role in  promoting the formation of cysts in the kidneys. 

V2R antagonists help reduce the action of vasopressin. This helps prevent cyst growth, which helps slow the decline of kidney function. It may also help reduce the cyst volume in any existing cysts.

How do you know if you are a good fit for V2R antagonists?

V2R antagonists are generally for people at a higher risk of severe PKD progression. Your care team will assess your risk through various methods, which may include imaging of your kidneys. 

An MRI is one form of imaging that, among other assessments, can help determine the volume of your kidneys. The size of the kidneys can help predict the course of PKD. In general, the larger the kidneys, the steeper the decline of kidney function.

“If you’re considered high risk to progression to kidney disease with PKD, your doctor would likely start you on a vasopressin antagonist to slow the progression,” says Scherly Leon, MD, Internist specializing in nephrology in New York City. 

Who is not an ideal candidate for V2R antagonists?

V2R antagonists have a small risk of causing very serious liver damage in some people. For this reason, some people may not be a good candidate for this medication.

Upon starting this treatment, your care team will regularly check your liver function with blood tests.

Talk to your healthcare provider to learn more about how V2R antagonists work, what the risks versus benefits are, and they’d be right for your PKD.

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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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