Raptis V, et al. - The levels of emerging biomarkers of endothelial function, angiogenesis and hypoxia (endocan, angiopoietin-2, and hypoxia-inducible factor-1a) were assessed in autosomal dominant polycystic kidney disease (ADPKD) patients with impaired renal function, in patients with preserved renal function, and age- and sex-matched controls with no history of renal disease, in order to gain clarity regarding a proposed alternative pathway of renal damage in ADPKD that involves endothelial dysfunction leading to unbalanced vasoconstriction and ischemia of renal parenchyma. Early in the course of ADPKD, patients may develop endothelial dysfunction causing microcirculatory changes, linked to angiogenesis and hypoxia. Overall, endothelial dysfunction could be a key regulator of renal injury progression in ADPKD patients.