Should a paediatrician perform abdominal ultrasonography in children of parents with polycystic kidney disease?
Krzysztof Wróblewski1, Katarzyna Młudzik2, Susan Afshari3, Piotr Grzelak4, Marcin Tkaczyk3,5
1 Department of Internal Medicine and Nephrodiabetology, Medical University of Lodz, Łódź, Poland
2 Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Łódź, Poland
3 Department of Paediatrics, Immunology and Nephrology, Polish Mother’s Memorial Hospital, Research Institute, Łódź, Poland
4 Department of Medical Imaging, Polish Mother’s Memorial Hospital, Research Institute, Łódź, Poland
5 Department of Paediatric Didactics, Medical University of Lodz, Łódź, Poland
Correspondence: Krzysztof Wróblewski, MD, PhD, Department of Internal Medicine and Nephrodiabetology, USK im. WAM, Medical University of Lodz, Żeromskiego 113, 90-549 Łódź, Poland,
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Autosomal dominant polycystic kidney disease produces symptoms mainly in adulthood. Renal cysts and/or elevated blood pressure can be the first signs of the disease in children. Because of the lack of a targeted therapy, early diagnosis and implementation of actions to slow its progression are the essence of treatment. Aim: The aim of the study was to assess the clinical course of autosomal dominant polycystic kidney disease in children. Material and methods: The study involved the assessment of 28 patients with autosomal dominant polycystic kidney disease diagnosed before the age of 18. The disease was diagnosed during a routine abdominal ultrasound scan in 24 patients and during a scan conducted due to abdominal pain reported by patients in 4 cases. Two patients had the disease diagnosed based on the Ravine criteria, whereas an ultrasound image and family history helped establish the diagnosis in 26 cases. The children enrolled had blood pressure measured, serum creatinine concentration determined and general urinalysis performed. Results: The median age at the diagnosis was 5 years. The family history was positive in 89.3% (25) of patients. Siblings had the disease in 46.43% (13) of cases. None of the children presented with abnormalities in urinalysis or creatinine levels. Two patients were diagnosed with arterial hypertension and in 1 child blood pressure was elevated above the 97th percentile. Urine albumin-to-creatinine ratio exceeding 30 mg/g was observed in 20.8% of children. Conclusions: Autosomal dominant polycystic kidney disease in children is asymptomatic. There are no irregularities either in urinalysis or renal function parameters. An abdominal ultrasound examination, which is inexpensive and non-invasive, is worth considering in all children of parents with autosomal dominant polycystic kidney disease in order to implement early nephroprotection.