A 15 yr old boy is noted to have enlarged kidneys with macrocysts seen bilaterally on a renal
ultrasound study after developing gross hematuria while playing hockey. His mother is 40 yr of
age and demonstrates similar findings on renal ultrasound examination. What is the most
appropriate next step in this patient's management?
□Evaluate the patient for kidney transplantation
■Check the blood pressure
□Obtain a cystogram to evaluate for vesicoureteral reflux
□Start the patient on an antibiotic for prevention of urinary tract infection
□Obtain a renal ultrasound study of all siblings
description: Treatment of ADPKD is primarily supportive. Control of blood pressure is critical because
the rate of disease progression in ADPKD correlates with the presence of hypertension. Angiotensinconverting
enzyme inhibitors and/or angiotensin II receptor antagonists are agents of choice. Obesity,
caffeine ingestion, smoking, multiple pregnancies, male sex, and possibly the use of calcium channel
blockers appear to accelerate disease progression. Older patients with a family history of intracranial
aneurysm rupture may be considered candidates for screening for aneurysms. (See Chapter 515, page
1798.Nelson Pediatrics 19th edn)
ultrasound study after developing gross hematuria while playing hockey. His mother is 40 yr of
age and demonstrates similar findings on renal ultrasound examination. What is the most
appropriate next step in this patient's management?
□Evaluate the patient for kidney transplantation
■Check the blood pressure
□Obtain a cystogram to evaluate for vesicoureteral reflux
□Start the patient on an antibiotic for prevention of urinary tract infection
□Obtain a renal ultrasound study of all siblings
description: Treatment of ADPKD is primarily supportive. Control of blood pressure is critical because
the rate of disease progression in ADPKD correlates with the presence of hypertension. Angiotensinconverting
enzyme inhibitors and/or angiotensin II receptor antagonists are agents of choice. Obesity,
caffeine ingestion, smoking, multiple pregnancies, male sex, and possibly the use of calcium channel
blockers appear to accelerate disease progression. Older patients with a family history of intracranial
aneurysm rupture may be considered candidates for screening for aneurysms. (See Chapter 515, page
1798.Nelson Pediatrics 19th edn)
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