PassMED: Medical Finals Examination Revision

Polycystic Kidney Disease

Incidental findings	AV fistula / peritoneal dialysis catheter
Signs	Bilateral masses in flanks, ballotable, can get above
Differential diagnosis	PCKD, hepatosplenomegaly
Tests	FBC - polycythaemia; U&E - function Dipstick - microscopic haematuria ECG - LVH USS kidneys CT / MR angio to screen for intracerebral aneurysms

Can present hypertension, loin pain, haematuria, subarachnoid, infection
77% patients with autosomal dominant polycystic kidney disease reach end-stage 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