Genetics and Autosomal Dominant Polycystic Kidney Disease Progression.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease, accounting for 10% of European patients on renal replacement therapy. In the previous years, many approaches to slow the progression of ADPKD were studied and many clinical trials published. In addition to having diagnostic role, the description of the genotype is even important to predict the progression of the disease and contributes, combined with several other factors, to a more precise patients classification. With the availability of disease-modifying drugs, "fast progression factors" are needed to early recognize those patients who would likely progress, before cyst growth reaches a critical value. ERA-EDTA working group on inherited kidney disorders included a series of recommendations resulting in a hierarchical decision algorithm to select patients who are most likely to benefit from the treatment. Beyond diagnosis, we will also discuss the important role of genetics in ADPKD progression and management.