KDIGO 2025 Clinical Practice Guideline for the Evaluation, Management, and Treatment of Autosomal Dominant Polycystic Kidney Disease (ADPKD)
Released in January 2025, this is KDIGO's first guideline dedicated to ADPKD. It covers genetic testing and imaging-based prognostication (Mayo imaging classification, PROPKD score), blood-pressure management, pain and cyst infection, polycystic liver disease, extrarenal manifestations, pregnancy and kidney replacement therapy. The one disease-modifying drug it can recommend is tolvaptan, reserved for patients at high risk of rapid progression — the two register trials below define that population and its eGFR range. Note that ADPKD was an exclusion criterion in SPRINT and in the major SGLT2-inhibitor CKD trials, so those recommendations do not transfer.
This guideline cites 2 of the 58 landmark trials in our Nephrology register.
Tolvaptan in early ADPKD (CKD G1–G3)1
- 2012TEMPO 3:4Nephrology · Cystic · ADPKDTolvaptan Efficacy and Safety in Management of ADPKD and its Outcomes
Tolvaptan in later-stage ADPKD (CKD G2–G4)1
- 2017REPRISENephrology · Cystic · ADPKDTolvaptan Safety and Efficacy in Later-Stage ADPKD