Pathogenesis and treatment of hypertension in polycystic kidney disease

Purpose of review Hypertension is common in patients with autosomal dominant polycystic kidney disease. It may contribute to cardiovascular risk and to progression of renal failure. Recent findings Apart from fluid overload and renin activation, hypertensive patients with autosomal dominant polycystic kidney disease also have increased sympathetic activity, regardless of renal function. Sympathetic hyperactivity not only contributes to the hypertension but may also increase cardiovascular risk independent of blood pressure. Summary Treatment for normalizing blood pressure and sympathetic activity should be started early in the course of the disease.