Fast Five Quiz: Autosomal Dominant Polycystic Kidney Disease Management

Neera K. Dahl, MD, PhD; Maryam Gondal, MD


September 08, 2022

Nonhypertensive patients with ADPKD who have normal renal function should undergo blood testing and ultrasonography of the kidneys every 1-2 years. More frequent follow-up studies should be scheduled for patients with high blood pressure and/or renal failure.

In patients with ADPKD, the vasopressin V2 receptor antagonist tolvaptan has been shown to reduce the rate of eGFR decline and reduce the rate of cyst growth. In the TEMPO 3:4 trial, tolvaptan reduced kidney growth by 45% and eGFR decline by 26% in early ADPKD (creatinine clearance > 60 mL/min) over 3 years. The REPRISE trial showed that tolvaptan slowed eGFR decline by 35% in advanced ADPKD (eGFR, 25-65 mL/min/1.73 m2) over 1 year.

Urinary tract infections are common in patients with ADPKD, and gram-negative bacteria are the most common pathogens.

Hematuria is common in patients with ADPKD and is normally the result of cyst rupture or stone passage. Patients should be advised to drink large amounts of water, rest, and to take a pain reliever if necessary. Hospitalization is not usually needed but may be required if the patient is still bleeding after several days or if the amount of blood is significant.

Learn more about the management of ADPKD.

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