title: Combination drug versus monotherapy for the treatment of autosomal dominant polycystic kidney disease.
abstract: BACKGROUND
  Despite progress in the understanding of pathogenetic mechanisms of organ cyst formation in autosomal dominant polycystic kidney disease, current treatment methods are insufficient. Experimental studies and clinical trials target at inhibition of cysts development and to slowing CKD progression.
  
  
  METHODS
  The purpose of this analysis is to overview available literature regarding treatment of ADPKD. The most important recent events concerning ADPKD treatment are: the results of TEMPO 3/4 study and the registration of tolvaptan in the treatment of patients with CKD stage I-III and rapidly progressive ADPKD by EMA. ERA-EDTA recommendations for use of tolvaptan in ADPKD of 2016 will be useful for the identification of patients with rapid progression of disease who will benefit most from treatment. Clinical trials concerning inhibitors of mTOR and SSAs have not delivered convincing evidence of their effectiveness. Usefulness of statins in ADPKD require confirmation in adults. The HALT-PKD study confirmed that inhibition of RAA system slows progression of ADPKD.
  
  
  CONCLUSIONS
  Current treatment of ADPKD involves: the optimization of life style and combined pharmacological treatment with ACE inhibitors or angiotensin receptor blockers, statins (patients with lipid disorders and cardiovascular disease) and tolvaptan (patients with stage I-III CKD and rapidly progressive ADPKD).
authors.affiliation: a Department of Nephrology, Hypertension and Family Medicine , Medical University of Lodz , Lodz , Poland.|c Healthy Aging Research Center , Medical University of Lodz , Lodz , Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
authors.affiliation: a Department of Nephrology, Hypertension and Family Medicine , Medical University of Lodz , Lodz , Poland.|c Healthy Aging Research Center , Medical University of Lodz , Lodz , Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Gluba-Brzózka
authors.affiliation: a Department of Nephrology, Hypertension and Family Medicine , Medical University of Lodz , Lodz , Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Franczyk
authors.affiliation: b Department of Hypertension , Medical University of Lodz , Lodz , Poland.|c Healthy Aging Research Center , Medical University of Lodz , Lodz , Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
authors.affiliation: a Department of Nephrology, Hypertension and Family Medicine , Medical University of Lodz , Lodz , Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Bartnicki
mesh_terms: D000328:Adult; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001552:Benzazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D006801:Humans; D016891:Polycystic Kidney, Autosomal Dominant / Q000188:drug therapy*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D000077602:Tolvaptan
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001552:Benzazepines; D000077602:Tolvaptan; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases
keywords: ACEi; ADPKD; ARB; cyst formation; somatostatin analogues; statins; tolvaptan