Polycystic Kidney Disease: Symptoms, Causes, Treatment

It differs from a common simple kidney cyst. Autosomal dominant disease is the more common form; recessive disease may present in childhood and also affect the liver. Cysts do not mean everyone will need dialysis.

Related reading: How can I protect kidney function, and is drinking lots of water enough?.

Symptoms may be absent for years, or include high blood pressure, flank pain, blood in urine, stones or urinary infection. Liver cysts and other complications can occur. Fever or acute pain should not automatically be attributed to uncomplicated cysts.

Gene changes affect kidney tubules and cyst formation. They may be inherited or newly arise, so absent family history does not exclude the condition. Age, imaging and family history help distinguish the form.

An affected relative and the particular genetic change inform disease risk. After diagnosis, kidney size, function and change over time help assess progression. Genetic counselling explains probabilities without guaranteeing a particular course.

Evaluation uses family history and ultrasound, MRI or CT when appropriate. Kidney function, blood pressure and urine are monitored. Genetic testing helps in selected circumstances, with counselling before family testing or pregnancy planning.

Care addresses blood pressure, pain, stones and infection while protecting the kidneys. Tolvaptan can slow dominant disease in selected adults at risk of rapid progression, with liver and fluid monitoring; it is not for every cyst or patient. Advanced failure requires individualized kidney-replacement or supportive-care discussion.

Complications can include infected or bleeding cysts, stones, hypertension and chronic kidney disease. Liver or vascular problems occur in some patients. Progression varies; repeated measurements are more informative than assuming the same outcome for every family.

Lifestyle cannot remove the genetic change. Blood-pressure control, less salt, avoiding smoking and reviewing medicines help protect kidney health. Fluid intake and activity should be individualized; avoid forced excessive drinking or frequent painkiller use without advice.