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Key Clinical Message  The mean age of onset of end‐stage renal disease ( ESRD ) in autosomal dominant polycystic kidney disease ( ADPKD ) is between 56 and 69. Our case represents one of the oldest patients with  ADPKD , whose chronic kidney disease ( CKD ) progression rate could be successfully reduced by optimal risk factor modification.

An 88‐year‐old patient with ADPKD : underscoring the importance of risk factor modification