ASYMPTOMATIC COMPLICATIONS OF AUTOSOMAL-DOMINANT POLYCYSTIC KIDNEY-DISEASE

To determine the possible affected family members of 40 autosomal dominant polycystic kidney disease (ADPKD) probands, we examined with ultrasonography 128 asymptomatic persons at risk who were older than 13 years and had not previously been diagnosed as having ADPKD. Sixty-five (50%) met ultrasound criteria for definite ADPKD, 60 (46%) had normal ultrasonogram and in 3 it was equivocal. Among the 65 ADPKD patients (mean age 33 years; range from 14 to 75 years), the complications at the time of diagnosis included: 29% were hypertensive, 10% had nephrolithiasis, 7% had impaired renal function and 6% presented urinary tract infection. A total of 24 patients (36%) had clinically significant complications and 10% had more than one complication. There is a strong association between hypertension and male gender: 13 of the 26 men (50%) and 6 of the 39 women (15%) were hypertensive (p=0.006). Therefore, earlier detection of the disease will permit effective treatment at an early stage and may have long-term benefits in delaying the progression of renal failure.