Polycystic Kidneys CT/MRI head Intracranial aneurysm

Adult PKD: Complications:

Prevalence 1:1000 Renal CRF
autosomal dominant; genes on chromosome 16 (PKD1 more severe) or 4 (PKD2) HPT due to increased renin secretion. Thus use ACEI as first-line agents.
Polycythemia due to erythropoietin secretion
DDx of bilateral renal cysts
Cyst infxn, haemorrhage
- Multiple simple cysts
Haematuria
- AR PKD in children
proteinuria
- Tuberous sclerosis
Renal calculi
- Von Hipple-Lindau syndrome
UTI/ pyelonephritis
CVS MVP, MR, AR, TR
Presentations CNS Berry aneurysm
Hematuria Renal calculi GI Colonic diverticula
HPT Renal failure Hernias of anterior abdominal wall
UTI SAH a/w berry aneurysm Cysts Liver, spleen, pancreas, testes, epididymis, ovaries, uterus, broad ligament, bladder,
Hx lungs, thyroid
Symptoms Loin pain
Haematuria Mx
Abdominal discomfort/pain due to enlarging kidneys Monitor BP & U/E
UTI Treat infxns
Renal calculi CRF Mx: dialysis, transplant
PMHx Stroke (berrys aneurysm) Genetic counseling children and siblings
HPT and its complications
FMHx PKD
Brain aneurysm (ask for death in the family at a young age)

Short Case examination

Peripheral Anaemia 2o to CRF
Polycythaemia due to increased erythropoiesis
AVF dialysis for CFR
Abdominal Hepatomegaly due to cystic dz
Palpable kidneys
Transplanted kidney
Hernias
Neurological 3rd nerve palsy & other signs of stroke
Request for invxs BP HPT
Urine dipstix microscopic haematuria
ECG left ventricular hypertrophy

Invx
FBC
U/E/Cr
Urine microscopy & C/S
U/S abdomen/ pelvis Cystic dz

DGIM Last updated March 2005