Ars Elisabet, Bernis Carmen, Fraga Gloria, Martínez Víctor, Martins Judith, Ortiz Alberto, Rodríguez-Pérez José Carlos, Sans Laia, Torra Roser
Molecular Biology Laboratory, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Barcelona, Spain.
Nephrology Department, Hospital de la Princesa, REDinREN, Madrid, Spain.
Nephrol Dial Transplant. 2014 Sep;29 Suppl 4:iv95-105. doi: 10.1093/ndt/gfu186.
Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent cause of genetic renal disease and accounts for 6-10% of patients on renal replacement therapy (RRT). Very few prospective, randomized trials or clinical studies address the diagnosis and management of this relatively frequent disorder. No clinical guidelines are available to date. This is a consensus statement presenting the recommendations of the Spanish Working Group on Inherited Kidney Diseases, which were agreed to following a literature search and discussions. Levels of evidence found were C and D according to the Centre for Evidence-Based Medicine (University of Oxford). The recommendations relate to, among other topics, the use of imaging and genetic diagnosis, management of hypertension, pain, cyst infections and bleeding, extra-renal involvement including polycystic liver disease and cranial aneurysms, management of chronic kidney disease (CKD) and RRT and management of children with ADPKD. Recommendations on specific ADPKD therapies are not provided since no drug has regulatory approval for this indication.
常染色体显性多囊肾病(ADPKD)是遗传性肾病最常见的病因,占接受肾脏替代治疗(RRT)患者的6% - 10%。针对这种相对常见疾病的诊断和管理,前瞻性随机试验或临床研究极少。目前尚无临床指南。这是一份共识声明,提出了西班牙遗传性肾病工作组的建议,这些建议是在文献检索和讨论后达成的。根据循证医学中心(牛津大学)的标准,所发现的证据级别为C级和D级。这些建议涉及多个主题,包括影像学和基因诊断的应用、高血压的管理、疼痛、囊肿感染和出血、肾外累及(包括多囊肝病和颅内动脉瘤)、慢性肾脏病(CKD)和RRT的管理以及ADPKD儿童的管理。由于尚无药物获得该适应症的监管批准,因此未提供关于特定ADPKD治疗方法的建议。