GPT and autosomal dominant polycystic kidney disease: Similar to two pivotal clinical trials of tolvaptan in the treatment of ADPKD, in which 4.4–5.6% of participants in the tolvaptan study arms had elevations in ALT >3 times the ULN reported [5], liver enzyme elevations were identified in a small percentage of patients treated with tolvaptan in this real-world clinical setting [75/2074 (3.6%) participants with ALT or AST ≥3 times the ULN].