KDIGO 2025 ADPKD

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.

Questa linea guida cita 2 dei 58 studi fondamentali del nostro registro di Nefrologia.

Fonte
Kidney Disease: Improving Global Outcomes (KDIGO) ADPKD Work Group. Kidney Int. 2025;107(2S):S1–S239. · Kidney International

Tolvaptan in early ADPKD (CKD G1–G3)1

  • 2012TEMPO 3:4Nefrologia · Cistica · ADPKDIn 1.445 pazienti con malattia renale policistica autosomica dominante, tolvaptan ha rallentato la crescita del volume renale totale rispetto al placebo.

Tolvaptan in later-stage ADPKD (CKD G2–G4)1

  • 2017REPRISENefrologia · Cistica · ADPKDIn 1.370 pazienti con ADPKD in stadio avanzato, tolvaptan ha rallentato il declino dell'eGFR rispetto al placebo.