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.
Esta norma cita 2 dos 58 ensaios marcantes do nosso registo de Nefrologia.
Tolvaptan in early ADPKD (CKD G1–G3)1
- 2012TEMPO 3:4Nefrologia · Cística · DRPADEm 1.445 doentes com doença renal poliquística autossómica dominante, o tolvaptano abrandou o crescimento do volume renal total em comparação com placebo.
Tolvaptan in later-stage ADPKD (CKD G2–G4)1
- 2017REPRISENefrologia · Cística · DRPADEm 1.370 doentes com DRPAD em estadio avançado, o tolvaptano abrandou o declínio da TFGe em comparação com placebo.