Polycystic Kidney Disease (PKD)

What is polycystic kidney disease (PKD)?

Polycystic kidney disease (PKD) is a rare genetic disorder. It causes numerous cysts filled with fluid to grow in the kidneys. PKD cysts can reduce kidney function, leading to kidney failure. PKD is the 4th leading cause of kidney failure. People with PKD can also have cysts in the liver and problems in other organs, such as the heart and blood vessels in the brain.

What are the different types of PKD?

There are 2 primary inherited forms of PKD and 1 noninherited form:

Autosomal dominant PKD (inherited)	This is the most common inherited form of polycystic kidney disease, accounting for about 90% of all PKD cases. Autosomal dominant means that if one parent has the disease, there is a 50% chance that the disease will pass to a child, and that both males and females are equally affected. These cases usually are diagnosed in adulthood. Usually, at least one parent must have the disease for a child to inherit it. In 10% of cases, there may be no family history of PKD. These cases are new mutations in a family. In very few cases, autosomal dominant PKD occurs suddenly after conception. Parents would not be at increased risk to have additional children with PKD. But people with PKD have a 50% chance of passing the gene on to their children. Autosomal dominant PKD is often called the adult polycystic kidney disease. Symptoms usually develop between age 30 and 40. But they can begin as early as childhood. They may include the following: Belly (abdominal) pain Belly grows larger Pale color to skin Bruise easily High blood pressure Kidney stones Brain aneurysms Diverticulosis Urinary tract infections Blood in the urine Liver and pancreatic cysts Abnormal heart valves Autosomal dominant PKD may occur with other conditions including: Tuberous sclerosis (a genetic syndrome involving seizures, intellectual disability, benign tumors, and skin lesions) Liver disease Severe eye problems The symptoms of autosomal dominant PKD may look like other conditions or medical problems. Always check with your child's healthcare provider for a diagnosis. Diagnosis of autosomal dominant PKD may include: Using imaging techniques to detect cysts on the kidney and other organs. Reviewing family history of autosomal dominant PKD. There are 3 different dominant genes which have been identified that further subdivide autosomal dominant PKD into PKD1, PKD2, and PKD3. Your child's healthcare provider will figure out a treatment plan for autosomal dominant PKD after careful consideration of the child's symptoms and medical history. Treatment may include: Pain medicine Surgery to shrink cysts and relieve pain Treatment for high blood pressure Treatment for urinary tract infections Dialysis Kidney transplantation
Autosomal recessive PKD (inherited)	Autosomal recessive PKD is a rare, inherited form of polycystic kidney disease. It is thought to be caused by a particular genetic flaw that is different from the genetic flaw that causes autosomal dominant PKD. Parents who don't have the disease can have a child with the disease if both parents carry the abnormal gene and both pass the gene to their child. Carrier parents have a 25% chance with each pregnancy to have a child with this type of PKD. Males and females are equally affected. Autosomal recessive PKD is sometimes detected before birth using a fetal ultrasound. Symptoms of autosomal recessive PKD can begin before birth. In most cases, the earlier symptoms start, the more severe the outcome. There are 4 different types of autosomal recessive PKD, depending on the child's age when symptoms become evident: Perinatal form (present at birth) Neonatal form (presents within the first month of life) Infantile form (presents between age 3 months and 6 months) Juvenile form (presents after age 1) Children born with autosomal recessive PKD may develop kidney failure within a few years and often experience the following: High blood pressure Urinary tract infections Frequent urination The disease also usually affects the liver, spleen, and pancreas. This results in low blood cell counts, varicose veins, and hemorrhoids. The symptoms of autosomal recessive PKD may look like other conditions or medical problems. Always check with your child's healthcare provider for a diagnosis. Diagnosis often includes ultrasound imaging of the fetus or newborn to reveal cysts in the kidneys. Ultrasound exam of kidneys of relatives may also be helpful. Your child's healthcare provider will figure out a treatment plan for autosomal recessive PKD after careful consideration of the child's symptoms and medical profile. Treatment may include: Treatment for high blood pressure Treatment for urinary tract infections Hormonal therapy Dialysis Kidney transplantation
Acquired cystic kidney disease, or ACKD (noninherited)	Acquired cystic kidney disease may develop in association with long-term kidney problems, especially in people who have kidney failure and who have been on dialysis for a long time. Therefore, it tends to occur later in life and is an acquired, not inherited, form of PKD. Often there are cysts in other organs, such as the liver and the pancreas.

Autosomal dominant PKD (inherited)

This is the most common inherited form of polycystic kidney disease, accounting for about 90% of all PKD cases. Autosomal dominant means that if one parent has the disease, there is a 50% chance that the disease will pass to a child, and that both males and females are equally affected. These cases usually are diagnosed in adulthood.
Usually, at least one parent must have the disease for a child to inherit it. In 10% of cases, there may be no family history of PKD. These cases are new mutations in a family. In very few cases, autosomal dominant PKD occurs suddenly after conception. Parents would not be at increased risk to have additional children with PKD. But people with PKD have a 50% chance of passing the gene on to their children.

Autosomal dominant PKD is often called the adult polycystic kidney disease. Symptoms usually develop between age 30 and 40. But they can begin as early as childhood. They may include the following:

Belly (abdominal) pain
Belly grows larger
Pale color to skin
Bruise easily
High blood pressure
Kidney stones
Brain aneurysms
Diverticulosis
Urinary tract infections
Blood in the urine
Liver and pancreatic cysts
Abnormal heart valves

Autosomal dominant PKD may occur with other conditions including:

Tuberous sclerosis (a genetic syndrome involving seizures, intellectual disability, benign tumors, and skin lesions)
Liver disease
Severe eye problems

The symptoms of autosomal dominant PKD may look like other conditions or medical problems. Always check with your child's healthcare provider for a diagnosis.

Diagnosis of autosomal dominant PKD may include:

Using imaging techniques to detect cysts on the kidney and other organs.
Reviewing family history of autosomal dominant PKD. There are 3 different dominant genes which have been identified that further subdivide autosomal dominant PKD into PKD1, PKD2, and PKD3.

Your child's healthcare provider will figure out a treatment plan for autosomal dominant PKD after careful consideration of the child's symptoms and medical history. Treatment may include:

Pain medicine
Surgery to shrink cysts and relieve pain
Treatment for high blood pressure
Treatment for urinary tract infections
Dialysis
Kidney transplantation

Autosomal recessive PKD (inherited)

Autosomal recessive PKD is a rare, inherited form of polycystic kidney disease. It is thought to be caused by a particular genetic flaw that is different from the genetic flaw that causes autosomal dominant PKD. Parents who don't have the disease can have a child with the disease if both parents carry the abnormal gene and both pass the gene to their child. Carrier parents have a 25% chance with each pregnancy to have a child with this type of PKD. Males and females are equally affected. Autosomal recessive PKD is sometimes detected before birth using a fetal ultrasound.

Symptoms of autosomal recessive PKD can begin before birth. In most cases, the earlier symptoms start, the more severe the outcome. There are 4 different types of autosomal recessive PKD, depending on the child's age when symptoms become evident:

Perinatal form (present at birth)
Neonatal form (presents within the first month of life)
Infantile form (presents between age 3 months and 6 months)
Juvenile form (presents after age 1)

Children born with autosomal recessive PKD may develop kidney failure within a few years and often experience the following:

High blood pressure
Urinary tract infections
Frequent urination

The disease also usually affects the liver, spleen, and pancreas. This results in low blood cell counts, varicose veins, and hemorrhoids.

The symptoms of autosomal recessive PKD may look like other conditions or medical problems. Always check with your child's healthcare provider for a diagnosis.

Diagnosis often includes ultrasound imaging of the fetus or newborn to reveal cysts in the kidneys. Ultrasound exam of kidneys of relatives may also be helpful.

Your child's healthcare provider will figure out a treatment plan for autosomal recessive PKD after careful consideration of the child's symptoms and medical profile. Treatment may include:

Treatment for high blood pressure
Treatment for urinary tract infections
Hormonal therapy
Dialysis
Kidney transplantation

Acquired cystic kidney disease, or ACKD (noninherited)

Acquired cystic kidney disease may develop in association with long-term kidney problems, especially in people who have kidney failure and who have been on dialysis for a long time. Therefore, it tends to occur later in life and is an acquired, not inherited, form of PKD. Often there are cysts in other organs, such as the liver and the pancreas.