A Kidney International commentary discusses the Lanreotide In Polycystic kidney disease Study (LIPS), described as the last randomised evaluation of somatostatin analogues in autosomal dominant polycystic kidney disease.
Lanreotide did not improve the primary outcome, decline in measured GFR, but suggested a benefit on the slope of creatinine-based estimated GFR. The commentators argue that this discrepancy illustrates how kidney function end points and statistical models can point in different directions, and that measured GFR should carry the weight.
Their conclusion is that the trial supports the KDIGO recommendation not to prescribe somatostatin analogues solely to preserve kidney function in ADPKD. Somatostatin analogues may still have a role for symptomatic polycystic liver disease, which is a separate question.
- Do not start a somatostatin analogue in ADPKD solely to preserve kidney function.
- Interpret an eGFR slope benefit with caution when measured GFR shows none.
- Continue established measures in ADPKD: blood pressure control, hydration advice and assessment for licensed therapy.
- Consider somatostatin analogues separately for symptomatic polycystic liver disease.
Why it matters
When measured and estimated GFR disagree, the measured result is the one to trust.
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