Polycystic kidney disease

Background

• Multisystemic and progressive disorder resulting in renal cysts and renal enlargement
• Hereditary disorder, autosomal dominant
• Accounts for ~2% of new cases of renal failure each year

Mortality

• Cardiovascular
• Infection, septicemia
• Subarachnoid hemorrhage
• Uremia

Clinical Features

• Clinical presentation typically begins in 3rd to 4th decade of life, but may be detectable in childhood
• Abdominal pain, flank pain and/or back pain is most common initial symptom.
  • Pain due to:
    • enlargement of cysts
    • bleeding within cyst or gross hematuria with clots or perinephric hematoma
    • urinary tract infection
    • nephrolithiasis
• Hematuria
  • self-limited
  • cysts are susceptible to traumatic injury
• Hypertension
  • common early manifestation
  • increased diastolic

Evaluation

Bedside ultrasound shows multiple renal cysts consistent with patient history of PKD

• Renal ultrasound is the imaging of choice
• CBC, BMP
• Urinalysis +/- Urine culture

References

• Torra R et al. Polycystic Kidney Disease. eMedicine. Feb 11, 2016. http://emedicine.medscape.com/article/244907-overview#showall