Autosomal Dominant Polycystic Kidney Disease (ADPKD) stands as the most prevalent hereditary renal disorder in humans, ultimately culminating in end-stage kidney disease. Animal models carrying mutations associated with polycystic kidney disease have played an important role in the advancement of ADPKD research. The Han:SPRD rat model, carrying an R823W mutation in the Anks6 gene, is characterized by cyst formation and kidney enlargement. The mutated protein, named Samcystin, is localized in cilia of tubular epithelial cells and seems to be involved in cystogenesis. The homozygous Anks6 mutation leads to end-stage renal disease and death, making it a critical factor in kidney development and function. This review explores the utility of the Han:SPRD rat model, highlighting its phenotypic similarity to human ADPKD. Specifically, we discuss its role in preclinical trials and its importance for investigating the pathogenesis of the disease and developing new therapeutic approaches.

Renal complications of HIV infection are common and histologically diverse. Besides HIV-associated nephropathy, which is the most well-defined glomerular disorder, immune-complex-mediated glomerulonephritis (HIVICK) is also encountered in the setting of HIV infection and may occasionally present with “lupus-like” features by light microscopy and immunofluorescence. Management of HIVICK remains controversial and mainly focuses on HIV viremia suppression with combined antiretroviral therapy. Immunosuppressive therapy may be used in order to mitigate the renal inflammation induced by the immune complex deposition. Data regarding the use of immunosuppressants in HIVICK are very limited, mostly including corticosteroids and mycophenolate acid analogues. Herein, we present the case of a 40-year-old HIV-infected Caucasian man with nephrotic syndrome, renal impairment, and a “lupus-like” membranous pattern in the kidney biopsy, who achieved a partial response of his proteinuria with a tacrolimus-based regimen in combination with antiretroviral therapy.

Background: Tolvaptan, a vasopressin V2 receptor antagonist, is the only approved disease-modifying therapy for Autosomal Dominant Polycystic Kidney Disease (ADPKD), yet real-world data on its long-term effectiveness remain limited. Methods: In this single-center retrospective study, we evaluated 30 patients with ADPKD who received tolvaptan therapy for at least three years between 2019 and 2024. All patients met standard inclusion criteria and underwent serial magnetic resonance imaging to assess total kidney volume (TKV), along with longitudinal monitoring of renal function using estimated glomerular filtration rate (eGFR). Results: At the end of follow-up, the median annual TKV growth rate was 4.27% (IQR: 1.39–7.98), which did not differ significantly from the predicted without treatment growth rate of 5.3% (95% CI: −2.75 to 0.69, p = 0.194). Although the impact on TKV was limited, tolvaptan notably slowed the decline in kidney function, with a median eGFR of 65 mL/min/1.73 m² at follow-up, compared to a predicted value of 60.8 mL/min/1.73 m² (95% CI: −14.60 to −6.18, p < 0.001), reflecting a 33.9% relative benefit. In 80% of patients, renal function after three years was better than predicted. Conclusions: These findings suggest that tolvaptan provides significant functional benefit in ADPKD patients in routine clinical practice, even in the absence of marked suppression in TKV growth and support its continued use in carefully selected individuals.