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Review
. 2022 Oct;45(5):167-170.
doi: 10.18773/austprescr.2022.052. Epub 2022 Oct 4.

Drug management of autosomal dominant polycystic kidney disease

Thiveya Theivendran  1   2 , Alister Ramachandran  1   2 , Gopi Rangan  1   2
Affiliations
Review

Drug management of autosomal dominant polycystic kidney disease

Thiveya Theivendran et al. Aust Prescr. 2022 Oct.

Abstract

Autosomal dominant polycystic kidney disease is the most common genetic kidney disease affecting adults. Approximately 60% of patients develop kidney failure by 60 years of age due to slowly expanding kidney cysts. A healthy lifestyle and rigorous control of blood pressure slow kidney cyst growth. These interventions can be effective in reducing progression to kidney failure and cardiovascular disease, especially if started in early adulthood. Tolvaptan, a vasopressin receptor antagonist, slows kidney cyst growth and the decline in the estimated glomerular filtration rate by 1 mL/minute/1.73 m2 per year. It is indicated in patients with chronic kidney disease who are at high risk of progression to kidney failure. Chronic kidney pain is common and can be managed with analgesics, and input from pain specialists if refractory.

Keywords: autosomal dominant polycystic kidney disease; hypertension; pain; tolvaptan.

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Conflict of interest statement

Conflicts of interest: Gopi Rangan was a principal investigator of grants from the National Health and Medical Research Council of Australia and conducted a clinical trial on prescribed water intake in ADPKD (GNT1138533, PREVENT-ADPKD study). He was also a principal investigator of a grant to conduct a clinical trial on prescribed water intake in ADPKD funded by Danone Research (France, manufacturer of bottled water). He is Chair, Scientific Advisory Board, PKD Australia (not-for-profit consumer group for patients with PKD). He is also a site investigator for clinical trials conducted with tolvaptan and a recipient of research grant funding from Otsuka Australia (manufacturer of tolvaptan).

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