Table 7.

Recommended Surveillance for Individuals with ADPKD

System/ConcernEvaluationFrequency
Kidney
  • CT or MRI of abdomen w/ & w/o contrast enhancement
  • Kidney ultrasound exam (if CT or MRI is unavailable)
Every 1-5 yrs beginning in adulthood, depending on disease stage
Blood pressure exam to detect hypertensionEvery 3 yrs beginning at age 5 yrs, in persons w/normal blood pressure
Urine studies for microalbuminuria or proteinuriaEvery 1-5 yrs beginning in adulthood, depending on disease stage
Aortic
dissection 		Echocardiography or chest MRI
  • Every 2-3 yrs in 1st-degree adult relatives of persons w/thoracic aortic dissection
  • Note: If aortic root dilatation is found, refer to cardiologist.
Cardiac valvular
abnormalities 		No surveillance recommended in persons w/o signs/symptoms
Intracranial
aneurysms 		Consider MRA in those w/: 1
  • Family history of intracranial aneurysms or subarachnoid hemorrhage;
  • Previous rupture of aneurysm;
  • Preparation for elective surgery w/potential hemodynamic instability;
  • High-risk occupation (e.g., airline pilot);
  • Significant anxiety despite adequate risk info.
Consider every 10 yrs beginning in adulthood. 2
Kidney cell
carcinoma 		No surveillance recommended in persons w/o concerning signs/symptoms
Colon
diverticulosis 		No surveillance recommended in persons w/o concerning signs/symptoms
1.

MRA is the diagnostic imaging modality of choice for presymptomatic screening because it is noninvasive and does not require intravenous contrast material. Most intracranial aneurysms found in asymptomatic individuals are small, have a low risk of rupture, and require no treatment [Irazabal et al 2011, Chapman et al 2015, Sanchis et al 2019], although dissenting opinions have been published [Rozenfeld et al 2014].

2.

One of 76 individuals with an initial normal MRA study had a new intracranial aneurysm after a mean follow up of 9.8 years [Schrier et al 2004].

From: Polycystic Kidney Disease, Autosomal Dominant

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