The most common inherited kidney disease, autosomal dominant polycystic kidney disease (ADPKD), determines 5% of all end-stage kidney disease. Tolvaptan, the only approved treatment for adults with ADPKD, is associated with an aquaretic effect and has a strong impact on patients’ daily life.
Irene Capelli, PhD, and colleagues conducted a literature review of analyses of possible nonpharmacological therapeutic strategies to slow enlargement of cysts as well as progression of chronic kidney disease. The strategies include dietary regimens reducing intake of carbohydrates and inducing ketoses. Results of preclinical and clinical studies have shown the efficacy of such strategies.
Other studies have demonstrated that strategies such as a ketogenic diet, caloric restriction, intermittent fasting, and time-restricted feeding can reduce aerobic glycolysis and inhibit the mammalian target of rapamycin (mTOR) pathway, resulting in a reduction in proliferation of cyst cells, as well as a reduction in kidney volume, and resulting preservation of kidney function
“ADPKD’s burden of disease has an impact on patients’ quality of life, and the possibility to play sports or carry out physical exercise can help people in everyday life,” the researchers said. “The multisystemic character of the disease, especially cardiovascular involvement, needs to be carefully evaluated to establish the quality and quantity of physical activity that patients can safely carry out.”