Blood tests in PKD
| Test | Finding in PKD |
|---|---|
| eGFR / creatinine | Declines as cysts replace kidney tissue — often stays normal for decades |
| Urine ACR | Proteinuria — indicates kidney damage |
| Haemoglobin | Relatively preserved (PKD kidneys make more erythropoietin than other CKD) |
| Urine culture | UTIs and cyst infections are common in PKD |
| Genetic testing (PKD1/PKD2) | Identifies mutation — PKD2 progresses more slowly than PKD1 |
How PKD is diagnosed
Ultrasound criteria by age
Autosomal dominant PKD (ADPKD) — the most common form — is diagnosed by renal ultrasound showing bilateral kidney cysts in someone with a family history. The number of cysts required for diagnosis varies by age: 15–39 years: at least 3 cysts total in both kidneys; 40–59 years: at least 2 cysts in each kidney; 60+ years: at least 4 cysts in each kidney. MRI provides more accurate total kidney volume (TKV) measurement, which predicts rate of progression.
Complications of PKD
| Complication | Details |
|---|---|
| Hypertension | Affects 70% of PKD patients — a major driver of progression |
| Kidney failure | 50% reach ESRD by age 60 (PKD1) or age 70 (PKD2) |
| Intracranial aneurysm | Affects 8% — screening MRA recommended with family history of rupture |
| Liver cysts | Common — usually asymptomatic but can cause abdominal distension |
| Cyst infection / haemorrhage | Presents as flank pain and fever |
Questions to ask your nephrologist
- What is my total kidney volume — am I a rapid progressor?
- Am I eligible for tolvaptan (Jynarque) to slow cyst growth?
- Should I be screened for intracranial aneurysms?
- Should my children be tested?
Medical Disclaimer: For educational purposes only. Always consult a qualified healthcare professional for diagnosis and treatment.