Fig. 1

Pathophysiological mechanisms associated with the initiation and progression of chronic kidney disease in autosomal dominant polycystic kidney disease. This schematic figure shows the negative influence of classical and renal or uremic-related cardiovascular risk factors in patients affected by ADPKD. The key to management these patients depend of the optimal approach and good control of these associated risk factors. The uses of novel therapies as vasopressin V2-receptor antagonist (Tolvaptan) may delay the progression of the renal disease specifically at the first step of the pathophysiological mechanisms related to proliferation and expansion of the cyst. Finally, if these measures are not taking in the early stages of ADPKD, a cascade of events can develop serious consequences. In addition, an activation of SRAA and SNS may produce vascular damage, increase the vascular resistance and renal fibrosis. All these activated mechanisms induce a chronic and irreversible damage in the kidneys. Abbreviations: SRAA, renin – angiotensin – aldosterone system; SNS, sympathetic nervous system; ADPKD, autosomal dominant polycystic kidney disease; CVD, cardiovascular disease; CKD, chronic kidney disease