Polycystic Kidney Disease (PKD)
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by multiple kidney cysts that enlarge over time, leading to high blood pressure, pain, recurrent infections, and progressive kidney failure.
At The Medical Group of New Jersey, nephrologists provide long-term monitoring, treatment for complications, and support for families navigating the genetic aspects of PKD.
Symptom Onset & Initial Evaluation
Polycystic kidney disease (PKD) may be discovered incidentally during imaging for another reason, or it may present with symptoms related to kidney enlargement or declining function. Common early signs include:
- High blood pressure at a young age
- Flank or abdominal pain
- Blood in the urine
- Recurrent urinary infections or kidney stones
- Enlarged kidneys that may be felt during a physical exam
During your initial evaluation, your nephrologist will:
- Review your personal and family history of PKD or kidney disease
- Assess kidney size, tenderness, and any signs of complications
- Evaluate cardiovascular risk factors, especially blood pressure
- Order imaging to confirm the presence and extent of kidney cysts
Diagnosis & Risk Assessment
Diagnosis of PKD typically involves a combination of imaging, lab testing, and selective genetic evaluation. Your nephrologist may recommend:
- Ultrasound, CT scan, or MRI, which reveal multiple cysts in both kidneys and help determine cyst burden
- Genetic testing, when necessary—such as in unclear cases, for potential kidney donors, or for family planning
- Kidney function tests to monitor creatinine, eGFR, and overall renal health
- Screening for associated conditions, which may include:
- Liver cysts
- Brain aneurysms (in patients with a strong family history or other high-risk factors)
This information helps determine disease severity and guides long-term management.
Treatment & Long-Term Management
The focus of treatment is to slow cyst growth and manage complications.
Blood Pressure Control
- RAAS blockers are preferred
- Sodium restriction
- Regular home blood pressure monitoring
Disease-Modifying Therapy
- Tolvaptan may be considered for patients at higher risk of rapid progression
Complication Management
- Pain control for cyst rupture or enlargement
- Antibiotics for cyst infection
- Management of kidney stones
- Avoiding nephrotoxic medications
Monitoring & Follow-Up
Your nephrologist will:
- Track kidney size with imaging
- Monitor kidney function and proteinuria
- Screen for aneurysms in high-risk groups
- Coordinate dialysis education or transplant referral when needed
Prognosis & Preventive Care
PKD progression varies widely. Many patients maintain kidney function for years with good blood pressure control. Early planning for Dialysis Management or Renal Transplant Care is beneficial for those with declining kidney function.
Preventive strategies include:
- Adequate hydration
- Avoiding caffeine and NSAIDs
- Maintaining a healthy body weight