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Published on: June 23, 2015
An update on treatments for autosomal dominant polycystic kidney disease
Suhani Janak Patel1, Catherine K Sadowski
1Suhani Janak Patel , a recent graduate of the PA program at Mercer University in Atlanta, Ga., practices in the ED at South Georgia Medical Center in Valdosta, Ga. Catherine K. Sadowski is a clinical associate professor in the PA program at Mercer University. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Insights
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder that can lead to end-stage renal disease. Early diagnosis and management, including new treatments like tolvaptan, are crucial for reducing disease progression.
Area of Science:
- Nephrology
- Genetics
- Internal Medicine
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is a significant genetic cause of end-stage renal disease (ESRD).
- Nonspecific symptoms often delay diagnosis, treatment, and patient education for ADPKD.
- ADPKD requires consideration in young patients presenting with ESRD, even without other comorbidities.
Purpose of the Study:
- To describe the characteristics of Autosomal dominant polycystic kidney disease (ADPKD).
- To outline current and emerging management strategies for ADPKD.
- To discuss the role of tolvaptan in mitigating ADPKD-related morbidity.
Main Methods:
- Review of existing literature on ADPKD diagnosis and management.
- Analysis of the mechanism of action and clinical trial data for tolvaptan.
- Discussion of patient selection criteria for tolvaptan therapy.
Main Results:
- ADPKD diagnosis can be delayed due to nonspecific symptoms.
- Tolvaptan demonstrates potential in reducing or delaying morbidity associated with ADPKD.
- Tolvaptan is an expensive treatment, limiting its use to a specific patient subset.
Conclusions:
- Early recognition of ADPKD is vital, particularly in young patients with ESRD.
- Tolvaptan offers a promising therapeutic option for managing ADPKD, though cost is a factor.
- Comprehensive patient education and timely management are essential for improving outcomes in ADPKD.
Abstract:
Autosomal dominant polycystic kidney disease (ADPKD) is less common than primary hypertension or diabetes but should be considered as a possible cause of end-stage renal disease, especially in young patients without comorbidities. Because of ADPKD's nonspecific symptoms, the diagnosis, treatment, and pertinent patient education may be delayed. This article describes ADPKD and its management, including tolvaptan, a new treatment with the potential to reduce or delay morbidity. However, only a subset of patients qualifies for this expensive treatment.
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