Polycystic kidneys
Incidental findings AV fistula / PD catheter
+ve signs Bilateral masses in flanks, ballotable, can get above
Differential diagnosis PCKD, hepatosplenomegaly
Function
Tests FBC – polycythaemia; U&e – renal function
Dipstick – microscopic haematuria
ECG – LVH
USS kidneys
CT / MR angio to screen for intracerebral aneurysms
Extensions

  • Look for III nerve palsy of previous subarachnoid / aneurysm
  • Ask to check the blood pressure
Notes

  • Can present hypertension, loin pain, haematuria, subarachnoid, infection
  • 77% patients with ADPKD reach endstage renal faiure or die by age of 70
  • Other features: Berry aneurysms; Mitral valve prolapse; hepatic cysts (more marked in infantile, AR form)
  • USS criteria for diagnosis in individuals at risk: Age <30 at least 2 cysts; 30-59 2 cysts in each kidney; >60 4 cysts in each kidney