Renal function was already decreased by age 20, at least in hypertensive children [20]. The important finding in the present study is that declining rates of eGFR and increasing rates of TKV are not significantly different Selleckchem GDC-0994 between normal blood pressure and high blood pressure patients after around 20 years. This phenomenon might or might not be due to anti-hypertensive treatment. The results of previous [20] and present studies suggest that renal functional deterioration starts

far earlier than 20 years of age, especially in hypertensive ADPKD patients. The potential limitations of this study include retrospective analysis, use of eGFR and 1/Cr, as well as an ethnically homogenous patient population in Japan, and hence it may not be applicable to other ethnicities. Conclusions In conclusion, eGFR starts to decline in young adult patients with apparently normal eGFR. After Adriamycin clinical trial adolescence, the declining rate of eGFR is relatively constant and does not relate to age or GFR. Hypertensive patients had lower eGFR and larger Selleck PU-H71 TKV than normotensive patients at young adult age. After adolescence, eGFR declined at a similar rate between normotensive and hypertensive groups. A long-term longitudinal study

starting in childhood is necessary to more thoroughly understand the characteristics of disease progression in ADPKD. Acknowledgments This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research from the Ministry of Health, Labor and Welfare of Japan. Conflict of interest Dr. Higashihara serves as consultant to Otsuka Pharmaceutical. Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are acetylcholine credited. Electronic supplementary material Below is the link to the electronic supplementary material. 1/Creatinine is plotted against age in all 255 patients (JPEG 87 kb) References 1. Franz KA, Reubi FC. Rate of

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