Abstract
A defect in urine-concentrating ability is discernable in patients with autosomal dominant polycystic kidney disease (ADPKD) before any decline in glomerular filtration rate, and is associated with elevated concentrations of vasopressin and copeptin. This defect is 'urea-selective' and accordingly, the urine-to-plasma ratio of urea concentration could be a clinically relevant early marker of renal dysfunction in patients with ADPKD.
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