Fast Five Quiz: Autosomal Dominant Polycystic Kidney Disease Management

Neera K. Dahl, MD, PhD


July 01, 2021

ACE inhibitors (eg, captopril, enalapril, lisinopril) or angiotensin II receptor blockers (ARBs), such as telmisartan, losartan, irbesartan, and candesartan, are the agents of choice for blood pressure control in patients with ADPKD. Conversely, calcium channel blockers should be considered as third- or fourth-line agents.

In a post hoc study of the TEMPO 3:4 trial, long-term treatment with the vasopressin V2 receptor antagonist tolvaptan was shown to gradually lower blood pressure compared with placebo. This may be the result of a beneficial effect on the progression of ADPKD, a continued natriuretic effect, or both. Tolvaptan is prescribed to patients with ADPKD to slow disease progression.

Among patients with advanced renal disease, both ACE inhibitors and ARBs may increase serum potassium levels or exacerbate renal failure. Regular monitoring of serum chemistry values in these patients is recommended.

Learn more about evolving insights into the management of ADPKD.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: