Summary
Definition
History and exam
Key diagnostic factors
- family history of autosomal-dominant PKD (ADPKD) or end-stage renal disease
- family history of cerebrovascular event
- renal cysts
- hypertension
- abdominal/flank pain
- hematuria
- palpable kidneys/abdominal mass
- headaches
- dysuria, suprapubic pain, fever
Other diagnostic factors
- cardiac murmur
- abdominal hernia
- hepatomegaly
- chest pain
Risk factors
- family history of autosomal-dominant PKD (ADPKD)
- family history of cerebrovascular event
Diagnostic tests
1st tests to order
- renal ultrasound
- CT abdomen/pelvis
- MRI abdomen/pelvis
- urinalysis/Gram stain and urine culture
- serum electrolytes, BUN, creatinine
- fasting lipid profile
- ECG
- CT brain
Tests to consider
- genetic testing
- echocardiogram
- 24-hour urine collection
- dual-energy CT of abdomen/pelvis
- lumbar puncture and cerebrospinal fluid analysis
- C-reactive protein
- PET scan
Treatment algorithm
confirmed autosomal-dominant polycystic disease
end-stage renal disease
Contributors
Authors
Marie C. Hogan, MD, PhD
Consultant
Division of Nephrology
Professor of Medicine
College of Medicine
Mayo Clinic
Rochester
MN
Disclosures
MCH receives research funding from Novartis, and was an investigator participating in tolvaptan clinical trials. MCH is also an author of several references cited in this topic.
Vicente Torres, MD, PhD
Professor
Division of Nephrology and Hypertension
Department of Internal Medicine
Mayo Clinic
Rochester
MN
Disclosures
VT is an author of several references cited in this topic.
Peer reviewers
Richard Sandford, PhD, FRCP
Wellcome Trust Senior Fellow in Clinical Research
University Reader in Real Genetics
Honorary Consultant in Medical Genetics
Cambridge
UK
Disclosures
RS declares that he has no competing interests.
Arlene Chapman, MD
Professor of Medicine
Renal Division
Emory University
School of Medicine
Atlanta
GA
Disclosures
Not disclosed.
Differentials
- Acquired cystic kidney disease
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