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balanced agonists, although the endothelin peptide scaffold does not appear suitable for designing such ligands.This is the first report to describe dose dependency in the effects of tolvaptan treatment for autosomal dominant polycystic kidney disease.The weight-adjusted average daily dose of tolvaptan was found to be a factor that significantly affected the change in eGFR.If a patient shows tolerance, increasing the tolvaptan dose to the maximum should be considered. Upper (UL) and lower limb (LL) cycling is extensively used for several