Polycystic Kidney Disease

Question 1

What other conditions is APKD associated with?

Answer 1

1. Intracranial aneurysms
2. Cardiovascular complications (commonest cause of death in APKD patients): LVH, biventricular diastolic dysfunction, valvular problems, pericardial effusion
3. Diverticulosis
   4.

Question 2

What is the Ravine’s criteria for risk of APKD?

Answer 2

20-30 years old: 1 cyst in each kidney or 2 cysts in one kidney
30-60 years old: 2 cysts in each kidney
>60 years old: 4 cysts in each kidney
Minimum cyst in kidneys required for the patient to be considered ‘at risk for APKD’.

Question 3

What associated conditions should be managed in a patient with APKD presenting with bilaterally enlarged kidneys?

Answer 3

1. UTI/infections
2. Hypertension
3. Pain management
4. Renal failure

Question 4

What antibiotics usually to treat UTI? Why?

Answer 4

1. Bactrim - sulfamethazole-trimethoprim
2. Fluoroquinolones
   Usually GN bacteria

Question 5

What are the surgical treatments for APKD? For polycystic kidney disease itself and for its complications.

Answer 5

Pyocyst (drainage)
Cystectomy
Nephrectomy
Alcohol sclerosant
RRT
Aneurysm clipping* (intracranial aneurysm assoc. with APKD)

Question 6

What are the clinical features of APKD?

Answer 6

1. Flank / loin pain
2. Enlarged kidneys
3. Haematuria (cyst rupture)
4. Recurrent UTI
5. Uraemia
6. HTN
7. Hepatosplenomegaly (hepatic cysts)
8. Strokes (intracranial aneurysms)
9. Murmur (valvular abnormalities)
10. Displaced apex beat (LVH)

Question 7

What other conditions can cause renal cysts?

Answer 7

1. VHL
2. TS (tuberous sclerosis - angiomyolipomas)
3. simple cysts

Question 8

What do people with APKD die of?

Answer 8

ESRF, strokes, HTN causes.