TY - CHAP M1 - Book, Section TI - Cystic Diseases of the Kidney A1 - Irazabal, Maria V. A1 - Torres, Vicente E. A2 - Lerma, Edgar V. A2 - Rosner, Mitchell H. A2 - Perazella, Mark A. PY - 2017 T2 - CURRENT Diagnosis & Treatment: Nephrology & Hypertension, 2e AB - Renal cystic disease includes a myriad of conditions characterized by the presence of multiple hereditary or acquired renal cysts, which differ in their clinical presentation, prognosis, and management. Renal cysts are composed of smooth-walled, enclosed fluid-filled circular structures that form in the kidney by focal out pouching of renal tubules. Although the mechanism underlying cyst formation remain to be fully elucidated, defects in the primary ciliary sensing mechanisms, intracellular calcium regulation, and cellular cyclic AMP (cAMP) accumulation have been shown to contribute to cyst formation in autosomal dominant and autosomal recessive polycystic kidney diseases (ADPKD and ARPKD), which represent a significant cause of morbidity and mortality in children and young adults. Currently, there are no FDA approved treatments for ADPKD, and the existing standard of care includes risk modification, management of complications, and renal replacement therapy with dialysis or organ transplantation. Several drugs designed to slow or arrest the progression of ADPKD have shown promise in preclinical models and clinical trials, including vasopressin receptor antagonists and somatostatin analogs. The vasopressin-2 receptor antagonist Tolvaptan has been the most successful drug therapy to reduce the rate of increase in total kidney volume (TKV) and ameliorate renal functional decline in patients with ADPKD. Further elucidation of the mechanisms implicated in cyst formation and development would provide impetus for correcting the underlying abnormalities in cystic pathways. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1149115998 ER -