Description
Autosomal dominant polycystic kidney disease (ADPKD), the most common inherited disorder in this country, is more than just a renal disease. Major extrarenal sites are the cardiovascular system, liver, and GI tract. The most devastating cardiovascular abnormalities are occult CNS aneurysms; screening for such lesions is indicated in selected patients, including those with a family history of both ADPKD and berry aneurysms. Liver cysts are a common manifestation of ADPKD; hormonal factors may cause these cysts to enlarge during pregnancy. Colonic diverticula affect most patients with ADPKD; consider diverticular rupture in your differential diagnosis when a patient presents with abdominal pain or peritoneal signs. Instrumentation (eg, cystoscopy) increases the risk of urinary tract infection in ADPKD patients and should be avoided when possible.