Rosh Internal Medicine Boost Practice Exam

What complication is most likely to develop in a patient with polycystic kidney disease?

1. End-stage renal disease

2. Intracranial aneurysms

3. Portal hypertension

4. Renal carcinoma

The correct answer is: End-stage renal disease

Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts in the kidneys. One of the most significant long-term complications of this condition is the progression to end-stage renal disease (ESRD). As the cysts expand, they can cause damage to the renal parenchyma, leading to a progressive decline in renal function over time. The accumulation of cysts can also lead to hypertension and electrolyte imbalances, further contributing to the deterioration of renal function. End-stage renal disease occurs when the kidneys can no longer maintain the balance of fluids, electrolytes, and waste products in the body, necessitating dialysis or kidney transplantation for survival. The lifetime risk of developing ESRD in patients with autosomal dominant polycystic kidney disease (ADPKD) can be as high as 50-75%, underscoring the high prevalence of this complication. While other complications can be associated with PKD, such as intracranial aneurysms and renal carcinoma, they do not occur as frequently or significantly affect the patient's outcome in the same way that ESRD does. It's essential for patients with PKD to be monitored for renal function over time to manage and prevent progression to end-stage