Why kidneys fail in autosomal dominant polycystic kidney disease

Patients with autosomal polycystic kidney disease develop cysts in a minority of their renal tubules, which can affect the function of a large number of nephrons. This Review analyzes the available facts on the development of renal failure in these patients to determine the respective effects of the cysts and the interstitial changes associated with them on the decline in glomerular filtration rate.