KDOQI US Commentary on the KDIGO 2025 Clinical Practice Guideline for the Evaluation, Management, and Treatment of Autosomal Dominant Polycystic Kidney Disease (ADPKD).

The Kidney Disease Outcomes Quality Initiative (KDOQI) convened a work group to review the 2025 KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guideline for the evaluation, management, and treatment of autosomal dominant polycystic kidney disease (ADPKD). The KDOQI work group reviewed the KDIGO guideline statements and practice points and provided perspective for implementation within the context of clinical practice in the United States. In general, the KDOQI work group concurs with several recommendations and practice points proposed by the KDIGO guidelines regarding the diagnosis, kidney manifestations of ADPKD, chronic kidney disease management and progression, and therapies to delay the progression of disease, along with management of extrarenal manifestations. The KDOQI work group acknowledges the growing evidence base to support a change in the nomenclature for ADPKD. In this commentary, the work group has also assessed and discussed various barriers and potential opportunities for implementing the recommendations put forth in the 2025 KDIGO guidelines while the scientific community continues to focus on prospective high-quality evidence to support specific recommendations for this systemic condition.