Dawaa Reference

chronic

Polycystic kidney disease

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Autosomal Dominant Polycystic Kidney Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK532934/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class UD55.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Polycystic kidney disease - disease-level clinical article (polycystic-kidney-disease-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (7)

  • Once GFR begins to fall, the decline is typically rapid, averaging 4.0 to 5.0 mL/minute per year.
  • High blood pressure is the earliest and most common presenting feature. [hypertension]
  • Visible blood in the urine can be the first symptom, from a bleeding cyst that communicates with the collecting system. [bleeding · blood in the urine · cyst]
  • Cyst hemorrhage causing gross hematuria is a frequent complication when the cyst opens into the collecting system. [bleeding · blood in the urine · cyst]
  • Kidney stones occur in about 20 to 25 percent of patients, most often uric acid or calcium oxalate. [kidney stones]
  • Polycystic liver disease is suspected once four or more cysts are seen in the liver parenchyma. [cyst]
  • Affected children usually have normal kidney function but higher rates of hypertension and protein in the urine than unaffected children. [hypertension · proteinuria]

Signs — what you find (3)

  • The most frequently seen heart abnormalities are mitral valve prolapse together with aortic regurgitation.
  • As many as half of patients also have diverticulosis. [diverticulosis]
  • Kidneys may be palpable on abdominal exam, particularly with a strong family history of the disease.

Tests (6)

  • The diagnosis is suspected with renal impairment plus multiple bilateral cysts on ultrasound or CT, with or without a known family history.
  • Diagnostic ultrasound thresholds rise with age: 2 or more cysts (either kidney) at 15-29 years, 2 or more per kidney at 30-59, and 4 or more per kidney at 60 and older.
  • Three or more cysts total between ages 15 and 39 has a 100% positive predictive value for the diagnosis.
  • Two or fewer cysts after age 40 has a 100% negative predictive value against the diagnosis.
  • Genetic testing for PKD1 and PKD2 is about 99% accurate but is not routinely needed for diagnosis.
  • If a child's initial screening ultrasound is negative, repeat screening is deferred until adolescence, around age 15 to 18.

If not this — what else fits (6)

  • Bardet-Biedl syndrome combines renal cysts with vision problems and obesity, so cysts alone do not define it.
  • HNF1B mutation causes renal cysts alongside early-onset diabetes, early-onset gout, a small pancreas, abnormal liver enzymes, and genital tract defects.
  • Unlike ADPKD, medullary sponge kidney doesn't lead to renal failure, though it's closely tied to nephrocalcinosis and kidney stones.
  • Tuberous sclerosis also causes renal cysts but comes with characteristic skin lesions like facial angiofibromas and connective tissue nevi.
  • Autosomal recessive PKD, unlike the dominant form, begins at or shortly after birth rather than in adulthood.
  • Orofaciodigital syndrome type I features facial, oral, and digit abnormalities, with renal cysts as a secondary finding.

SourceStatPearls "Autosomal Dominant Polycystic Kidney Disease" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

An inherited disorder causing progressive kidney cysts and eventual kidney failure; the GP recognises the diagnosis, often via family history or imaging, and refers to nephrology for monitoring. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

An inherited disorder causing progressive kidney cysts and eventual kidney failure; the GP recognises the diagnosis, often via family history or imaging, and refers to nephrology for monitoring.

Cautions
  • RED FLAG - Infected renal cyst or acute pyelonephritis requiring urgent admission and targeted parenteral antibiotics: assess urgently and refer.
  • RED FLAG - Ruptured intracranial berry aneurysm presenting as sudden thunderclap headache: assess urgently and refer.
  • High blood pressure, blood in the urine, or declining kidney function in a known polycystic kidney disease patient needs prompt nephrology involvement.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Cerebral aneurysm is the most serious extrarenal complication of ADPKD (4x higher prevalence than general population).
  • RED FLAG - Severe cyst hemorrhage causing hemodynamic instability requires emergency hospitalization and transfusion.

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