A commentary in Kidney International discusses the Lanreotide In Polycystic kidney disease Study (LIPS), described as the last randomised evaluation of somatostatin analogues in autosomal dominant polycystic kidney disease. The commentary reports that lanreotide did not show a beneficial effect on the primary outcome, decline in measured glomerular filtration rate. It did suggest an effect on the slope of creatinine-based eGFR.
The commentators highlight the discrepancy between the two outcomes and the difficulty of interpreting kidney function end points and statistical models. They conclude that LIPS supports the current KDIGO recommendation not to prescribe somatostatin analogues solely to preserve kidney function in ADPKD.
The abstract carries no effect sizes, and the trial itself is not reported here, so this section relies on the commentary's reading. Somatostatin analogues may be used for other reasons in ADPKD, such as symptomatic polycystic liver disease, which this commentary does not address.
- Per the commentary, LIPS supports not prescribing a somatostatin analogue solely to preserve kidney function in ADPKD.
- Measured GFR, the primary outcome, did not improve with lanreotide.
- A signal on creatinine-based eGFR slope did not match the measured GFR result.
- Where a patient is already on an analogue for kidney function alone, review the indication.
Why it matters
It leaves the guideline unchanged and shows how the choice of kidney function measure can alter a trial's apparent result.
Don't overread it
This is a commentary, not the trial report, and it addresses kidney function preservation only.
The statistics, in plain English
Two kidney function measures disagreed: measured GFR showed no benefit while creatinine-based eGFR slope suggested one. Creatinine-based eGFR can change for reasons unrelated to the kidney's filtering, so the directly measured result carries more weight.
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