Treatments and Therapies for ADPKD

Your doctor may prescribe a number of medications depending on your symptoms or complications of ADPKD.

Kidney cyst growth

In 2018, the Food and Drug Administration (FDA) approved the medication tolvaptan (Jynarque) to treat ADPKD.

This medication helps slow the growth of cysts that occur with ADPKD. This helps limit kidney damage and reduce the risk of kidney failure.

There’s a risk of liver injury or drug interaction when taking tolvaptan. Work with a doctor who specializes in kidney health for the best outcome.

Tolvaptan can only be used in adults who have:

• stage 2 or 3 chronic kidney disease at the start of treatment
• evidence of progressing kidney disease

Common side effects of tolvaptan (Jynarque) include:

• blurred vision
• difficulty breathing or labored breathing
• dry mouth or dry skin
• frequent urination
• fruit-like breath odor
• increased hunger or thirst
• increased urination or volume of diluted urine
• nausea, vomiting, or stomach pain
• sweating
• unexplained weight loss
• unusual weakness or fatigue

High blood pressure

High blood pressure can contribute to the progression of the disease.

Your doctor may recommend lifestyle changes and potentially medications such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) to help manage your blood pressure.

Infections

Urinary tract infections (UTIs), such as bladder or kidney infections, related to ADPKD can be treated with antibiotics. A longer course of treatment may be required if the infection is more complicated than a simple bladder infection.

Pain

Over-the-counter treatments such as acetaminophen can help to relieve any pain associated with:

• cysts in the kidneys
• infections
• kidney stones

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are usually not recommended due to their ability to interfere with blood pressure medications and kidney function.

Anti-seizure medications can also be used to help with ease pain caused by nerve damage. These include pregabalin (Lyrica) and gabapentin (Neurontin).

If pain can’t be controlled with these methods, your doctor may consider prescribing other pain medications such as opioids. Opioids have unique side effects and the potential for dependence, so work with your doctor to find the lowest dose needed to help manage your pain.

Always talk to your doctor before taking a new type of medication, including over-the-counter pain relievers. Some pain relievers and other medications may be harmful to your kidneys.

What you eat may have significant effects on your kidney health, as well as your blood pressure. Staying well hydrated makes a difference, too, and can aid in passing kidney stones and preventing UTIs.

To help you develop eating habits that meet your health needs, your doctor may refer you to a dietitian. They can help you learn which foods to include in your eating plan and which to limit or avoid.

For example, they may encourage you to:

• limit salt, or sodium, in your diet as much as possible to help reduce your blood pressure
• eat smaller portions of high-quality protein to protect your kidneys
• reduce your consumption of trans- and saturated fats as much as you can for heart health
• avoid eating too much potassium or phosphorous
• limit how much alcohol you drink

It’s also important to drink enough fluids to stay well hydrated. Researchers are currently studying how hydration affects the condition.

If you develop complications of ADPKD, your doctor may recommend surgery as part of your treatment plan.

For example, they may prescribe surgery if you develop:

• cysts in your kidneys or other organs that cause severe pain that can’t be managed with medications
• severe or recurrent diverticulitis, which may affect the wall of your colon
• a brain aneurysm, which may affect blood vessels in your brain

The types of surgical options for ADPKD include:

• Surgical cyst drainage. Infected cysts that don’t respond to antibiotic treatment can be drained of fluid with a needle.
• Open or fiberoptic-guided surgery. This can drain the outer walls of cysts to relieve pain.
• Removal of the kidney (nephrectomy). Removal of part or all of the kidneys can be a more extreme option for cysts that cannot be shrunk or removed via other methods.
• Partial removal of the liver (hepatectomy) or transplantation. For enlargement of the liver or other related liver complications, partial removal of the liver or a liver transplant may be recommended.

Surgery may help relieve certain complications of the condition. However, it won’t slow the overall development of ADPKD.

Your kidneys perform an essential function by filtering waste products and excess water from your blood.

If you develop kidney failure, you’ll need dialysis or a kidney transplant to survive.

There are two main types of dialysis:

• hemodialysis
• peritoneal dialysis

In hemodialysis, an external machine is used to filter your blood outside of your body. In peritoneal dialysis, your abdominal area is filled with dialysate (dialyzing fluid) to filter your blood inside your body.

If you receive a kidney transplant, a surgeon will transplant a healthy donor kidney from another person into your body. It may take years to find a good donor kidney match.

Certain complementary therapies may help lower your stress or pain levels. This may help reduce your blood pressure and promote better quality of life with ADPKD.

Activities that can help with stress or pain management include:

• massage
• acupuncture
• meditation
• yoga
• tai chi

Practicing an overall healthy lifestyle is also important for helping to manage your blood pressure and promote good kidney health. For example, try to:

• get enough sleep
• exercise regularly
• avoid smoking

Always talk to your doctor before trying a new complementary therapy or making major changes to your lifestyle. They can help you learn if the therapy or changes are safe for you.

Never take herbal medications or vitamin supplements without talking to your doctor to learn if they’re safe. Many herbal products and vitamin supplements may damage your kidneys.

Although ADPKD currently has no cure, your doctor may recommend medications, treatments, lifestyle strategies, and in some cases, surgery to help manage the condition.

Let your doctor know if you develop any new symptoms or other changes in your health. They may recommend adjustments to your treatment plan.

Talk to your doctor to learn more about the potential benefits, risks, and costs of different treatment options.