What Is The Standard of PKD Diagnosis

What is the standard of PKD diagnosis? Here is a brief introduction of Adult PKD which refers to autosomal dominant inheritance PKD.

Ⅰ. Familial history.

Ⅱ. Clinical symptoms

Firstly, symptoms of urinary system: most patients do not have symptoms until they get around 40 years old. They can get pain on waist and back or renal colic. Symptoms of Haematuria, upper urinary tract infection and complicated Kidney Stone appear, or even symptoms of Chronic Renal Failure, like headache, nausea, vomiting as well as tiredness and weight loss can be found.

Secondly, symptoms of cardiovascular system: High Blood Pressure usually happens as one of the primary symptoms, complicated with left ventricular hypertrophy, mitral valve prolapse, aortic insufficiency as well as intracranial aneurysm and other diseases.

Thirdly, symptoms of digestive system: 30% to 40% PKD patients accompany with liver cyst and 10% PKD patients get pancreatic cyst. While about 5% patients may have spleen cyst at the same time.

Ⅲ. Body Check

Patients can be found unilateral or bilateral kidneys with nodular condition when touched. Pressing pain can be felt if there is a infection. 50% patients have increased waist size.

Ⅳ. Assistant Test.

Firstly, routine urine test: there is no abnormality in urine test in the early stage of PKD. Microscopic Haematuria can be found in middle and late stage of this disease,and some patients may get Albuminuria. White Blood Cells and pyocyte can be found if there is a complicated Stone or infection.

Secondly, test on urine osmotic pressure: even there is only a few cysts in early stage of pathological change, manifestation of renal concentrated function injury can be found, showing that this change in not related with renal structure damage only, it may be related with renal adverse reaction to anti-diuretic hormone. Under such circumstance, renal concentrated function declines before glomerular filtrating rate decrease.

Thirdly, serum creatinine is increasing with the loss of renal compensatory ability. Creatinine clearance rate is a sensitive index in this condition.
Fourthly, plain film of KUB shows enlarged kidney image with irregular shape.
Fifth, IVP shows deformation of renal pelvis and renal calices caused by cystic pressure. Renal pelvis and renal calices can be in a shape of spider. Renal calices is wide and plain with thin and stretched calices neck.

Sixth, through Type-B Ultrasonic examination, a larger amount of shadow area can be found in kidney region.


Seventh, through CT examination, bilateral kidneys enlargement can be found with thin cysts filled with cyst fluid.