Condition Guide

Polycystic Kidney Disease (PKD)

Name: Polycystic Kidney Disease (PKD): Blood Tests & Symptoms
Creator: Suman Konda
Published: 2026-07-05

PKD is the most common inherited kidney disease, causing fluid-filled cysts that gradually replace kidney tissue. Blood tests and imaging track its progression.

Written by Suman Konda, PharmD, Clinical Pharmacist · Based on peer-reviewed sources · Editorial policy · Not medical advice

Last updated: 01 August 2026 · How we check our content

Blood tests in PKD

Test	Finding in PKD
eGFR / creatinine	Declines as cysts replace kidney tissue: often stays normal for decades
Urine ACR	Proteinuria: indicates kidney damage
Haemoglobin	Relatively preserved (PKD kidneys make more erythropoietin than other CKD)
Urine culture	UTIs and cyst infections are common in PKD
Genetic testing (PKD1/PKD2)	Identifies mutation: PKD2 progresses more slowly than PKD1

How PKD is diagnosed

Ultrasound criteria by age

Autosomal dominant PKD (ADPKD), the most common form, is diagnosed by renal ultrasound showing bilateral kidney cysts in someone with a family history. The number of cysts required for diagnosis varies by age: 15–39 years: at least 3 cysts total in both kidneys; 40–59 years: at least 2 cysts in each kidney; 60+ years: at least 4 cysts in each kidney. MRI provides more accurate total kidney volume (TKV) measurement, which predicts rate of progression.

Complications of PKD

Complication	Details
Hypertension	Affects 70% of PKD patients: a major driver of progression
Kidney failure	50% reach ESRD by age 60 (PKD1) or age 70 (PKD2)
Intracranial aneurysm	Affects 8%: screening MRA recommended with family history of rupture
Liver cysts	Common: usually asymptomatic but can cause abdominal distension
Cyst infection / haemorrhage	Presents as flank pain and fever

Questions to ask your nephrologist

What is my total kidney volume: am I a rapid progressor?
Am I eligible for tolvaptan (Jynarque) to slow cyst growth?
Should I be screened for intracranial aneurysms?
Should my children be tested?

Frequently Asked Questions

Is polycystic kidney disease inherited?

Most cases are autosomal dominant, meaning a parent with the condition has a 50% chance of passing it to each child. A rarer recessive form appears in infancy.

How is it monitored?

Regular blood pressure checks, kidney function tests (eGFR, creatinine), and imaging track the condition, since well-controlled blood pressure helps slow progression.

Does everyone with PKD need dialysis?

No. Progression varies. Many maintain adequate kidney function for decades, though some do progress to kidney failure needing dialysis or transplant, which is why monitoring matters.

References

The clinical information on this page is drawn from peer-reviewed sources indexed by the US National Library of Medicine. Links go to the source so you can read it yourself.

Chronic Kidney Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK535404