Fast Five Quiz: Autosomal Dominant Polycystic Kidney Disease Presentation and Diagnosis

Neera K. Dahl, MD, PhD


June 29, 2021

Although it is not common, patients with well-developed renal cysts and even patients with chronic renal failure can have normal-sized kidneys on radiographs. Evaluation of total kidney volume is emerging as an accurate measure of cyst burden and a prognostic predictor of renal function in ADPKD. In addition, liver, pancreas, and spleen cysts may help to confirm the diagnosis of ADPKD.

Localized thickening of the Gerota fascia may be seen on CT in patients with cyst infection and renal abscess. Infected cysts typically have thick, uneven walls that often calcify.

MRI of the kidneys is a beneficial technique for classification of renal masses and can be used in addition to or instead of CT. However, as with images obtained from intravenous urography and CT, MRI scans of simple renal cysts of nongenetic etiology can look like scans of lesions associated with ADPKD. This is also true for cysts associated with von Hippel-Lindau disease or tuberous sclerosis. For characterizing complicated cysts, however, MRI is probably superior to other imaging modalities.

Learn more about the workup of ADPKD.

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