Start Here Patient guide

Start here with ADPKD

Focus on the decisions that matter now. You do not need to learn everything at once.

Evidence reviewed: August 24, 2026

On this page

Your first steps

Confirm who is coordinating your kidney care.
A nephrologist with ADPKD experience can review family history, kidney function, imaging, blood pressure, and complications together.
Track your blood pressure correctly.
Ask for your personal target. KDIGO 2025 uses a home blood pressure target of 110/75 mmHg or lower for selected adults ages 18 to 49 with CKD G1 to G2 and hypertension, if tolerated. For adults age 50 or older, it suggests standardized office systolic blood pressure below 120 mmHg, if tolerated. An ACE inhibitor or ARB is the usual first-line treatment for hypertension.
Collect the trend, not just one result.
Bring prior creatinine and eGFR results, imaging reports, medication lists, and family history to your visit. Change over time is more useful than one eGFR value.

Know your risk of progression

No single test predicts the future perfectly. A specialist usually combines several signals:

eGFR trend

Several years of kidney function results can show whether decline is slow or rapid. KDIGO uses a historical eGFR decline of at least 3 mL/min/1.73 m² per year as one marker of rapid progression.

Mayo Imaging Classification

For typical ADPKD imaging, classes 1C to 1E can indicate rapid progression. The 1B to 1C boundary needs clinical judgment, and the system is not designed for atypical imaging patterns.

Clinical context

Age, genotype, early hypertension, kidney complications, and family history can change how imaging and eGFR results are interpreted.

What helps now

Blood pressure treatment: lowers cardiovascular risk and is a core part of ADPKD care.
Tolvaptan: can slow kidney function decline in eligible adults with eGFR at least 25 mL/min/1.73 m² and evidence of rapid progression. It requires shared decision-making, liver monitoring, and planning for increased thirst and urination.
Lower sodium intake: supports blood pressure management. KDIGO advises less than 2 g of sodium per day for most adults, with individual adjustments when needed.
Regular monitoring: catches blood pressure, kidney function, pain, stones, infection, liver cyst, and cardiovascular concerns early.

Treatment overview Tolvaptan guide Slowing progression

What is not proven

There is no clinically proven cure for ADPKD.
Prescribed high water intake did not slow kidney growth in a three-year randomized trial. Hydration should be individualized because too much water can be unsafe for some people.
KDIGO does not recommend SGLT2 inhibitors specifically to slow ADPKD progression. Current human evidence is insufficient and randomized trials are underway.
No supplement has proven disease-modifying benefit in ADPKD.

Build your care plan

Use the topic pages when the decision comes up. Keep the first appointment focused on your current risk, monitoring plan, blood pressure, and whether tolvaptan should be discussed.

Questions for your nephrologistTake a short checklist to your visit Symptoms and urgent signsKnow what can wait and what cannot Food and hydrationPractical guidance without unsupported claims Daily lifeExercise, food, hydration, and sustainable habits Research and clinical trialsActive studies and the current cure reality

Medical Disclaimer

This resource provides educational information about ADPKD and is not a substitute for professional medical advice. Always discuss treatment decisions, symptoms, and health concerns with your nephrologist or primary care physician before making any changes.

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