proteinuria autosomal dominant polycystic kidney disease

Q: Proteinuria is the earliest feature of so far undiagnosed autosomal dominant polycystic kidney disease (ADPKD)?

A) True

B) False

Answer: B

Unlike other major causes of renal failure, proteinuria is not a remarkable feature of ADPKD. It occurs late in the course. If nephrotic syndrome type picture emerges in a patient with ADPKD, it signifies a superimposed glomerular disease. 

ADPKD occurs slow and major signs and symptoms (S/S) include progressive enlargement of the renal cysts. In fact, measured total kidney volume is considered the strongest predictor of the impending renal failure. Other S/S  may be hypertension, frequent urinary tract infections, gross hematuria, kidney stones, and acute and/or chronic flank/abdominal pain.

#nephrology

References:

1. Chapman AB, Bost JE, Torres VE, et al. Kidney volume and functional outcomes in autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol 2012; 7:479.

2. Chapman AB, Johnson AM, Gabow PA, Schrier RW. Overt proteinuria and microalbuminuria in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 1994; 5:1349.