Nephrology & Renal Medicine

Autosomal Dominant Polycystic Kidney Disease (ADPKD)

ICD-10 Code

Q61.2_2

Most common genetic kidney disease, caused by mutations in PKD1 (~85%) or PKD2 (~15%). Characterized by progressive, bilateral cystic expansion of the renal parenchyma, leading to massive renal enlargement, hypertension, flank pain, hematuria, and eventual progression to ESRD. Associated with hepatic cysts and berry aneurysms.

Clinical Presentation & Protocol

Patient Usually Complains Of

Patient presents for follow-up of ADPKD. Reports [stable/worsening] flank pain, intermittent gross hematuria, and nocturia. Denies recent fever, dysuria, or flank trauma. Current BP management: [medication list]. Family history positive for ADPKD and ESRD.

Clinical Examination Findings

General: Patient appears [well/chronically ill]. Abdomen: Significant bilateral flank fullness/masses palpated, non-tender to mild tenderness. Renal bruits absent. Skin: No stigmata of connective tissue disorders.

Treatment Protocol

Plan: 1. Strict BP control (target <130/80 mmHg) via ACEi/ARB. 2. Tolvaptan therapy initiated/continued for rapid progressors. 3. High fluid intake (>3L/day). 4. Low sodium diet (<2g/day). 5. Monitor eGFR and serum electrolytes q3-6 months.

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