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Nazareno Carullo,1 Maria Teresa Zicarelli,1 Alessandro Casarella,2 Ramona Nicotera,1 Alberto Castagna,2 Alessandra Urso,1 Pierangela Presta,1 Michele Andreucci,1 Emilio Russo,2 Davide Bolignano,1 Giuseppe Coppolino1 1Renal Unit, Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy; 2Department of Health Sciences, “Magna Graecia” University, Catanzaro, ItalyCorrespondence: Giuseppe CoppolinoRenal Unit, Department of Health Sciences, “Magna Graecia” University, Viale Europa - Germaneto, Catanzaro, 88100, ItalyTel +39 09613697170Email gcoppolino@unicz.itAbstract: Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent single-gene disorder leading to renal failure. Current therapies are aimed to treat renal and extrarenal complications of ADPKD, but improved knowledge of the pathophysiological mechanisms leading to the generation and growth of cysts has permitted the identification of new drug candidates for clinical trials. Among these, in this review, we will examine above all the role of metformin, hypothesized to be able to activate the AMP-activated protein kinase (AMPK) pathway and potentially modulate some mechanisms implicated in the onset and the growth of the cysts.Keywords: cystogenesis, renal cells, metformin, chronic renal disease, renal tubule