eMedicine Specialties > Radiology > Genitourinary

Autosomal Dominant Polycystic Kidney Disease: Follow-up

Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP, Chairman of Medical Imaging, Professor of Radiology, NGHA, King Fahad National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Coauthor(s): Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK; Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Contributor Information and Disclosures

Updated: Dec 23, 2008

Intervention

Image-guided aspiration of a cyst in which infection is suspected may confirm the diagnosis of autosomal dominant polycystic kidney disease, provide tissue for culture and sensitivity, and eventually provide a route for percutaneous drainage. Large uninfected cysts causing pressure effects also can be aspirated. Transcatheter embolization may be considered for a ruptured cyst with active bleeding.

Medicolegal Pitfalls

  • Imaging features of an acutely infected cyst usually are those of a simple cyst; however, if infection is acute or chronic, imaging features may be those of an abscess or necrotic tumor.
    • Differentiating an infected simple cyst from an abscess may be extremely difficult, both clinically and on imaging. In both lesions, evidence may exist of infected debris.
    • In addition, calcification may occur in both.
  • Aspiration of simple cysts causing pressure effects should be performed with extra care because cysts are particularly prone to infection.
  • With currently available techniques, little need exists for retrograde pyelography, because of the increased risk of urinary tract infections in patients with autosomal dominant polycystic kidney disease.

Special Concerns

  • Early diagnosis of autosomal dominant polycystic kidney disease is desirable because it allows for genetic counseling, planning of optimal therapy, and screening of siblings.
 


More on Autosomal Dominant Polycystic Kidney Disease

Overview: Autosomal Dominant Polycystic Kidney Disease
Imaging: Autosomal Dominant Polycystic Kidney Disease
Follow-up: Autosomal Dominant Polycystic Kidney Disease
Multimedia: Autosomal Dominant Polycystic Kidney Disease
References
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References

  1. Higashihara E, Aso Y, Shimazaki J, Ito H, Koiso K, Sakai O. Clinical aspects of polycystic kidney disease. J Urol. Feb 1992;147(2):329-32. [Medline].

  2. Itai Y, Ebihara R, Eguchi N, Saida Y, Kurosaki Y, Minami M, et al. Hepatobiliary cysts in patients with autosomal dominant polycystic kidney disease: prevalence and CT findings. AJR Am J Roentgenol. Feb 1995;164(2):339-42. [Medline].

  3. Kaplan BS, Kaplan P, Rosenberg HK, et al. Polycystic kidney diseases in childhood. J Pediatr. Dec 1989;115(6):867-80. [Medline].

  4. Milutinovic J, Fialkow PJ, Rudd TG, et al. Liver cysts in patients with autosomal dominant polycystic kidney disease. Am J Med. May 1980;68(5):741-4. [Medline].

  5. Parfrey PS, Bear JC, Morgan J, et al. The diagnosis and prognosis of autosomal dominant polycystic kidney disease. N Engl J Med. Oct 18 1990;323(16):1085-90. [Medline].

  6. Pei Y, He N, Wang K, Kasenda M, Paterson AD, Chan G, et al. A spectrum of mutations in the polycystic kidney disease-2 (PKD2) gene from eight Canadian kindreds. J Am Soc Nephrol. Oct 1998;9(10):1853-60. [Medline].

  7. Bisceglia M, Galliani CA, Senger C, Stallone C, Sessa A. Renal cystic diseases: a review. Adv Anat Pathol. Jan 2006;13(1):26-56. [Medline].

  8. Masoumi A, Reed-Gitomer B, Kelleher C, Bekheirnia MR, Schrier RW. Developments in the management of autosomal dominant polycystic kidney disease. Ther Clin Risk Manag. Apr 2008;4(2):393-407. [Medline].

  9. Rohatgi R. Clinical manifestations of hereditary cystic kidney disease. Front Biosci. May 1 2008;13:4175-97. [Medline].

  10. Torres VE, Rossetti S, Harris PC. Update on autosomal dominant polycystic kidney disease. Minerva Med. Dec 2007;98(6):669-91. [Medline].

  11. Ariyurek Y, Lantinga-van Leeuwen I, Spruit L, et al. Large deletions in the polycystic kidney disease 1 (PKD1) gene. Hum Mutat. Jan 2004;23(1):99. [Medline].

  12. Pei Y. Diagnostic approach in autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. Sep 2006;1(5):1108-14. [Medline].

  13. Auranen M, Ala-Mello S, Turunen JA, Jarvela I. Further evidence for linkage of autosomal-dominant medullary cystic kidney disease on chromosome 1q21. Kidney Int. Oct 2001;60(4):1225-32. [Medline].

  14. Deltas CC. Mutations of the human polycystic kidney disease 2 (PKD2) gene. Hum Mutat. 2001;18(1):13-24. [Medline].

  15. Koptides M, Deltas CC. Autosomal dominant polycystic kidney disease: molecular genetics and molecular pathogenesis. Hum Genet. Aug 2000;107(2):115-26. [Medline].

  16. Bisceglia M, Galliani C, Carosi I, Simeone A, Ben-Dor D. Tuberous Sclerosis Complex With Polycystic Kidney Disease of the Adult Type: The TSC2/ADPKD1 Contiguous Gene Syndrome. Int J Surg Pathol. Jul 8 2008;[Medline].

  17. Meijer E, de Jong PE, Peters DJ, Gansevoort RT. Better understanding of ADPKD results in potential new treatment options: ready for the cure?. J Nephrol. Mar-Apr 2008;21(2):133-8. [Medline].

  18. Birewar S, Zawada ET Jr. Early onset polycystic kidney disease: how early is early?. S D J Med. Nov 2003;56(11):465-8. [Medline].

  19. Dahnert W. Radiology Review Manual. 4th ed. Baltimore, Md: Lippincott Williams & Wilkins. 1999: 782.

  20. Nakajima F, Shibahara N, Arai M, et al. Intracranial aneurysms and autosomal dominant polycystic kidney disease: followup study by magnetic resonance angiography. J Urol. Aug 2000;164(2):311-3. [Medline].

  21. Schievink WI, Torres VE, Piepgras DG, Wiebers DO. Saccular intracranial aneurysms in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. Jul 1992;3(1):88-95. [Medline].

  22. Currie RJ, Freeman SJ, McCormick F, McGonigle RJ. Polycystic kidneys: a cautionary story. Br J Radiol. Dec 2007;80(960):e305-9. [Medline].

  23. Gulanikar AC, Daily PP, Kilambi NK, et al. Prospective pretransplant ultrasound screening in 206 patients for acquired renal cysts and renal cell carcinoma. Transplantation. Dec 27 1998;66(12):1669-72. [Medline].

  24. Torra R, Sarquella J, Calabia J, Martí J, Ars E, Fernández-Llama P, et al. Prevalence of cysts in seminal tract and abnormal semen parameters in patients with autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. May 2008;3(3):790-3. [Medline].

  25. Antiga L, Piccinelli M, Fasolini G, Ene-Iordache B, Ondei P, Bruno S, et al. Computed tomography evaluation of autosomal dominant polycystic kidney disease progression: a progress report. Clin J Am Soc Nephrol. Jul 2006;1(4):754-60. [Medline].

  26. Perrone R. Imaging progression in polycystic kidney disease. N Engl J Med. May 18 2006;354(20):2181-3. [Medline].

  27. Gardner KD Jr, Evan AP. Cystic kidneys: an enigma evolves. Am J Kidney Dis. May 1984;3(6):403-13. [Medline].

  28. Almaden Y, Hernandez A, Torregrosa V, Canalejo A, Sabate L, Fernandez Cruz L, et al. High phosphate level directly stimulates parathyroid hormone secretion and synthesis by human parathyroid tissue in vitro. J Am Soc Nephrol. Oct 1998;9(10):1845-52. [Medline].

  29. Bajwa ZH, Gupta S, Warfield CA, Steinman TI. Pain management in polycystic kidney disease. Kidney Int. Nov 2001;60(5):1631-44. [Medline].

  30. Basaria S, Mehta NN. Renal and extrarenal autosomal dominant polycystic kidney disease. Postgrad Med J. Dec 2000;76(902):814. [Medline].

  31. Chapman AB, Rubinstein D, Hughes R, Stears JC, Earnest MP, Johnson AM, et al. Intracranial aneurysms in autosomal dominant polycystic kidney disease. N Engl J Med. Sep 24 1992;327(13):916-20. [Medline].

  32. Chatha RK, Johnson AM, Rothberg PG, et al. Von Hippel-Lindau disease masquerading as autosomal dominant polycystic kidney disease. Am J Kidney Dis. Apr 2001;37(4):852-8. [Medline].

  33. Chauveau D, Fakhouri F, Grunfeld JP. Liver involvement in autosomal-dominant polycystic kidney disease: therapeutic dilemma. J Am Soc Nephrol. Sep 2000;11(9):1767-75. [Medline]. [Full Text].

  34. Chicoskie C, Chaoui A, Kuligowska E, et al. MRI isolation of infected renal cyst in autosomal dominant polycystic kidney disease. Clin Imaging. Mar-Apr 2001;25(2):114-7. [Medline].

  35. Fick-Brosnahan GM, Tran ZV, Johnson AM, et al. Progression of autosomal-dominant polycystic kidney disease in children. Kidney Int. May 2001;59(5):1654-62. [Medline].

  36. Grampsas SA, Chandhoke PS, Fan J, et al. Anatomic and metabolic risk factors for nephrolithiasis in patients with autosomal dominant polycystic kidney disease. Am J Kidney Dis. Jul 2000;36(1):53-7. [Medline].

  37. Grunfeld JP, Chauveau D, Joly D. Polycystic kidney disease: >. J Nephrol. Jul-Aug 1999;12 Suppl 2:S42-6. [Medline].

  38. Keadle DM, Bauman JM, Billingsley JL. Nonvisualization of the liver on a Tc-99m sestamibi parathyroid scan. Clin Nucl Med. Nov 2000;25(11):921-2. [Medline].

  39. Kondo A, Akakura K, Ito H. Assessment of renal function with color Doppler ultrasound in autosomal dominant polycystic kidney disease. Int J Urol. Mar 2001;8(3):95-8. [Medline].

  40. Kwok CG, McDougall IR. Persistent fever in a patient with polycystic kidney and liver diseases and bilateral hip prostheses. J Nucl Med. Dec 1996;37(12):2062-5. [Medline].

  41. Lilova MI, Petkov DL. Intracranial aneurysms in a child with autosomal recessive polycystic kidney disease. Pediatr Nephrol. Dec 2001;16(12):1030-2. [Medline].

  42. Martignoni G, Bonetti F, Pea M, et al. Renal disease in adults with TSC2/PKD1 contiguous gene syndrome. Am J Surg Pathol. Feb 2002;26(2):198-205. [Medline].

  43. Milutinovic J, Agodoa LC, Cutler RE, et al. Autosomal dominant polycystic kidney disease. Early diagnosis and consideration of pathogenesis. Am J Clin Pathol. Jun 1980;73(6):740-7. [Medline].

  44. Mizoguchi M, Tamura T, Yamaki A, et al. Genotypes of autosomal dominant polycystic kidney disease in Japanese. J Hum Genet. 2002;47(1):51-4. [Medline].

  45. Nascimento AB, Mitchell DG, Zhang XM, et al. Rapid MR imaging detection of renal cysts: age-based standards. Radiology. Dec 2001;221(3):628-32. [Medline].

  46. Neureiter D, Frank H, Kunzendorf U, et al. Dialysis-associated acquired cystic kidney disease imitating autosomal dominant polycystic kidney disease in a patient receiving long-term peritoneal dialysis. Nephrol Dial Transplant. Mar 2002;17(3):500-3. [Medline]. [Full Text].

  47. Nicolau C, Torra R, Bianchi L, et al. Abdominal sonographic study of autosomal dominant polycystic kidney disease. J Clin Ultrasound. Jul-Aug 2000;28(6):277-82. [Medline].

  48. Roy A, Soni GR, Kolhapure RM, Banerjee K, Patki PS. Induction of tumour necrosis factor alpha in experimental animals treated with hepatotoxicants. Indian J Exp Biol. Aug 1992;30(8):696-700. [Medline].

  49. Sise C, Kusaka M, Wetzel LH, et al. Volumetric determination of progression in autosomal dominant polycystic kidney disease by computed tomography. Kidney Int. Dec 2000;58(6):2492-501. [Medline].

  50. Somlo S, Markowitz GS. The pathogenesis of autosomal dominant polycystic kidney disease: an update. Curr Opin Nephrol Hypertens. Jul 2000;9(4):385-94. [Medline].

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Further Reading

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Keywords

autosomal dominant polycystic kidney disease, Potter type III disease, adult polycystic kidney disease, kidney disease, polycystic kidney disease, renal cyst, ADPKD, ADPCKD, renal failure, hypertension, impaired renal function, PKD1, PKD2, PKD3

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Contributor Information and Disclosures

Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP, Chairman of Medical Imaging, Professor of Radiology, NGHA, King Fahad National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP is a member of the following medical societies: American Institute of Ultrasound in Medicine, Radiological Society of North America, Royal College of Physicians, Royal College of Physicians and Surgeons of the United States, Royal College of Radiologists, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Coauthor(s)

Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK
Disclosure: Nothing to disclose.

Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Sumaira MacDonald, MBChB, PhD, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

John L Haddad, MD, Clinical Associate Professor, Department of Radiology, Weill Medical College of Cornell University; Director of Body MRI, Department of Radiology, Methodist Hospital in Houston
John L Haddad, MD is a member of the following medical societies: American College of Radiology, American Medical Association, and Radiological Society of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Arnold C Friedman, MD, FACR, Associate Chairman, Department of Radiology, University of Florida Health Science Center; Chief, Department of Radiology, Shands-Jacksonville Hospital
Arnold C Friedman, MD, FACR is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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