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Polycystic Kidney Disease (PKD)

Polycystic Kidney Disease (PKD) is a genetic condition, causing multiple cysts to form in kidneys, therefore significantly impairing its function. More commonly an autosomal dominant inheritance, but it can be autosomal recessive.

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Gross pathology of polycystic kidneys - Centers for Disease Control and Prevention

It's associated with Cerebral berry aneurysms. These most commonly form at the junction between the anterior communicating artery and anterior cerebral artery.


Hepatic cysts are its most common extra-renal manifestation.


Presents with:

  • HTN

  • Flank pain and haematuria with cyst rupture

  • Flank pain, fever and urinary symptoms with cyst infection


Investigations - Renal US

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“Advanced polycystic kidney disease with multiple cysts” © Kristoffer Lindskov Hansen, Michael Bachmann Nielsen and Caroline Ewertsen (Licensed under CC-BY 4.0) https://creativecommons.org/licenses/by/4.0/

Management

  • Manage CKD and HTN

  • Tolvaptan (ADH receptor antagonist), which slows down cyst development and progression of renal decline


Complications

  • Cyst rupture

  • Cyst infection

  • CKD

  • Subarachnoid haemorrhage due to berry aneurysm



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