Question

What is NOT true with regard to the adult polycystic kidney?

• A. Hematuria
• B. Hypertension is rare
• C. Autosomal dominant transmission
• D. Cysts are seen in the liver, spleen and pancreas

Hint:

Hypertension is one of the earliest and most common findings in ADPKD, not a rare one.

Answer 1

The Correct Option is B

Adult (autosomal dominant) polycystic kidney disease has a well defined set of features, and this question wants the one statement that does not match them.

1. Hematuria: True. Cysts can bleed into the urinary tract or rupture, so blood in the urine is a common finding.
2. Hypertension is rare: False. Hypertension is actually very common in ADPKD, often appearing even before the kidneys start to fail, because the enlarging cysts activate the renin-angiotensin system.
3. Autosomal dominant transmission: True. This is the defining inheritance pattern, caused mainly by mutations in the PKD1 or PKD2 genes.
4. Cysts are seen in the liver, spleen and pancreas: True. ADPKD is a systemic disease of cyst formation, and cysts are commonly found in the liver, and less often in the spleen and pancreas, along with the kidneys.

Since hypertension is actually one of the most common and earliest features of ADPKD rather than a rare one, that statement is the false one.

Let's summarize:

• ADPKD commonly causes hematuria, hypertension, and cysts in other organs besides the kidney.
• Calling hypertension "rare" in ADPKD is incorrect; it is one of the earliest and most common findings.

So the correct answer is that hypertension is rare.