Laboratorio de Biología Molecular, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Barcelona, Spain.
Servicio de Nefrología, Hospital de la Princesa, REDinREN, Instituto de Investigación Carlos III, Madrid, Spain.
Nefrologia (Engl Ed). 2022 Jul-Aug;42(4):367-389. doi: 10.1016/j.nefroe.2022.11.011. Epub 2022 Nov 17.
Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent cause of genetic renal disease and accounts for 6-10% of patients on kidney replacement therapy (KRT). 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 revised consensus statement from the previous 2014 version, 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 mostly are 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 KRT and management of children with ADPKD. Recommendations on specific ADPKD therapies are provided as well as the recommendation to assess rapid progression.
常染色体显性遗传性多囊肾病(ADPKD)是最常见的遗传性肾脏疾病,占肾脏替代治疗(KRT)患者的 6-10%。非常少有的前瞻性、随机试验或临床研究涉及这种相对常见疾病的诊断和管理。迄今为止,尚无临床指南。这是对以前 2014 年版本的修订共识声明,介绍了西班牙遗传性肾脏疾病工作组的建议,这些建议是在进行文献检索和讨论后达成的。根据牛津大学循证医学中心(Centre for Evidence-Based Medicine)的标准,证据水平大多为 C 和 D。这些建议涉及其他主题,包括影像学和基因诊断的使用、高血压、疼痛、囊肿感染和出血、包括多囊性肝病和颅内动脉瘤在内的肾脏外表现、慢性肾脏病(CKD)和 KRT 的管理以及 ADPKD 患儿的管理。还提供了关于特定 ADPKD 治疗的建议,以及建议评估快速进展的建议。