MosaicED Brain Teaser!
A 50 year old plumber is referred to the ED by his GP due his low eGFR and deranged LFTs. He had gone to the GP due to flank pain and some haematuria. On examination his blood pressure is 180/110, and he has bilateral palpable flank masses. He has never been to hospital before but his mother died at 40 from a brain aneurysm.
What is the most likely diagnosis?
- A-Acute interstitial nephritis
- B-Acute tubular necrosis
- C-Autosomal dominant polycystic kidney disease
- D-Autosomal recessive polycystic kidney disease
- E-Hepatorenal syndrome
- F-Nephrotic syndrome
- G-Nephritic syndrome
- H-Reflux nephropathy
- I-Renal tubular acidosis
- J-Sickle-cell nephropathy
Answer:C-Autosomal dominant polycystic kidney disease . PKD (Polycystic kidney disease) is split into autosomal dominant PKD and autosomal recessive. ADPKD is adult onset and less severe. Symptoms include flank pain, palpable flank mass, diverticular disease, hypertension, and haematuria. Complications include liver cysts (the deranged LFTs), cardiac problems, aneurysms (mothers death), UTIs, infected renal cysts, and nephrolithiasis. Treat the complications, eg control blood pressure, treat UTIs, manage pain, and end stage renal failure requires a transplant.