KHA-CARI autosomal dominant polycystic kidney disease guideline: Diet and lifestyle management
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ADPKD is characterized by the progressive substitution of renal tubules by hundreds of cysts,resulting in the gradual loss of functioning nephrons and CKD. ADPKD is a progressive life-long disease,and, like CKDingeneral,it is associated with increased cardiovascular disease risk. As hypertension is strongly associated with end-organ damage in ADPKD, blood pressure (BP) control is a critical therapeutic target.Therefore,modifiable diet and life-style risk factors,including exercise and sodiumi ntake, are considered in this review. In addition, the progression of renal cyst growth in ADPKD is influenced by increased intracellular levels of cyclic adenosine monophosphate (cAMP) in epithelial cells lining the renal cysts, and this is responsible, inpart, for increased cellular proliferation and transepithelial cystic fluid secretion, leading to cystgrowth. In this regard, antidiuretic hormone (ADH) is a mediator of cAMP production in cystic epithelial cells. Both fluid and caffeine intake have been hypothesized to influence cAMP production and are therefore also reviewed in later sections for evidence related to their role in renal cyst growth.
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