Riding the waves: Evidence for a beneficial effect of increased water intake in autosomal dominant polycystic kidney disease patients?

摘要

Autosomal dominant polycystic kidney disease (ADPKD) can lead to end-stage kidney disease and accounts for ~10% of people receiving renal replacement therapy. Until recently, no treatment had been proven to effectively postpone kidney failure. Interestingly, experimental studies that have been published over the past decades have suggested a detrimental role for the antidiuretic hormone arginine vasopressin (AVP) in ADPKD. V2 receptor activation by AVP was discovered to result in an increase of 3',5'-cyclic adenosine monophosphate (cAMP) [1]. In turn, cAMP stimulates cell proliferation and fluid secretion, leading to cyst formation and cyst growth [2-4]. ADPKD patients appeared to have high serum levels of AVP, and AVP levels were, in cross-sectional studies, associated with disease severity [5] and, in longitudinal studies, with disease progression [6, 7].