Caffeine Consumption in Autosomal Dominant Polycystic Kidney Disease (ADPKD)
Patients with ADPKD should avoid excessive caffeine intake, but moderate caffeine consumption appears to be safe and does not significantly accelerate disease progression. 1
Current Evidence on Caffeine and ADPKD
Clinical Studies on Caffeine and Disease Progression
- The 2025 KDIGO clinical practice guideline for ADPKD recommends avoiding excessive caffeine intake, particularly during pregnancy, but does not advise complete elimination 1
- Multiple clinical studies have failed to demonstrate a significant detrimental effect of moderate caffeine consumption on ADPKD progression:
- A 12.5-year prospective study (CRISP cohort) found that caffeine consumers had only slightly faster kidney growth (0.6% per year) but maintained smaller kidney volumes throughout the study and showed no significant difference in GFR decline or progression to end-stage renal disease 2
- The Swiss ADPKD longitudinal cohort study (median follow-up 4.38 years) found no statistically significant difference in height-adjusted total kidney volume or estimated GFR between coffee and non-coffee drinkers 3
- A cross-sectional study showed no correlation between caffeine intake and renal volume in ADPKD patients 4
Animal Studies
- Early animal research suggested potential concerns, with one study showing chronic caffeine consumption exacerbated hypertension in rats with polycystic kidney disease, though it did not affect cyst development or GFR 5
Practical Recommendations
Caffeine Consumption Guidelines
- Follow the general KDIGO guideline recommendation to avoid excessive caffeine intake 1
- Based on animal studies, limiting caffeine to the equivalent of four or fewer cups of coffee per day appears reasonable 5
- Pay special attention to limiting caffeine during pregnancy 1
Other Important Lifestyle Considerations for ADPKD Patients
- Maintain normal body weight, as obesity accelerates renal function loss in ADPKD 6
- Follow a low-sodium diet (<2000 mg/day) to help control blood pressure 6
- Consume moderate protein (0.6-0.8 g/kg/day for CKD stages 3-5) 6
- Drink according to thirst and avoid dehydration, as ADPKD patients are more sensitive to water deprivation 6
- Limit alcohol to ≤1 drink/day for females and ≤2 drinks/day for males 1
Special Considerations
Monitoring and Follow-up
- Regular blood pressure monitoring is essential, as hypertension is common in ADPKD and may be exacerbated by caffeine 1
- Work with registered dietitians for individualized nutritional counseling, particularly for patients with advanced CKD, high risk for urinary stones, or obesity 1, 6
Common Pitfalls
- Avoid making blanket recommendations for complete caffeine elimination, as this is not supported by current evidence and may unnecessarily restrict quality of life
- Remember that caffeine is found not only in coffee but also in tea, soft drinks, energy drinks, chocolate, and some medications
- Don't overlook the importance of other lifestyle factors (sodium restriction, weight management) that may have greater impact on disease progression than moderate caffeine consumption
While early laboratory studies raised concerns about caffeine in ADPKD, more recent and robust clinical evidence suggests that moderate caffeine consumption does not significantly accelerate disease progression. The focus should remain on established risk factors like hypertension control, weight management, and sodium restriction.