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Recent advances in genetics, imaging, and disease pathophysiology have enabled earlier diagnosis and improved risk stratification and led to the development of disease-modifying therapies (such as tolvaptan) for high-risk patients. Despite the availability of comprehensive clinical practice guidelines, real-world implementation is hindered by disease heterogeneity, psychosocial impacts, and the need for individualized care. The aim of this narrative review is to facilitate guideline implementation by integrating evidence from patient perspectives and real-world effectiveness and offering strategies to overcome practical barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.0000001113","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:04:35Z","timestamp":1775145875000},"page":"1319-1331","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Treatment of Autosomal Dominant Polycystic Kidney Disease"],"prefix":"10.1681","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2147-0998","authenticated-orcid":false,"given":"Gopi","family":"Rangan","sequence":"first","affiliation":[{"name":"Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney and Department of Renal Medicine, Westmead Hospital, Western Sydney 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