Do you stop tolvaptan below a certain eGFR in a patient with autosomal dominant polycystic kidney disease?

In general, the practical guidelines support continuing tolvaptan until dialysis or transplant (Chebib and Torres, PMID 33705818). There are situations where I will discontinue sooner, either due to apparent lack of benefit, due to precipitous, unexpectedly rapid decline or accelerated decline, or, ...