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Presentation of ARD(acquired renal cystic disease) 1.Flank pain 2.UTI 3.visible haematuria 4. renal colic (stone disease); 5.hypertension. •Investigation 1.This depends on the presenting symptoms. 2. For suspected UTI: culture urine. 3. For haematuria: urine cytology, flexible cystoscopy, and renal USS. 4.On USS(ultrasound scanning), the kidneys are small and hyperechoic, with multiple cysts of varying size, many of which show calcification. 5.If the nature of the cysts cannot be determined with certainty on USS, arrange a renal CT

Treatment of renal fusion Treatment. No treatment is necessary unless complication(Obstruction, hydronephrosis, stone, & infection) is present

Laboratory findings of ADPKD 1.Anemia may be noted. 2.Proteinuria and microscopic (if not gross) hematuria are the rule 3.Pyuria and bacteriuria are common. 4.Elevated renal indices 5.IVU: the renal masses are usually enlarged &caliceal pattern is quite bizarre ( called spider leg deformity). 6.Ultrasound is superior to excretory IVU in the diagnosis. 7.CT scanning in most of cases give an accurate diagnosis.

Sign of ADPKD 1.one or both kidneys are usually palpable. 2. They may feel nodular. 3. If it is infected they may be tender. 4.Hypertension is found in 60 % of these patients. 5.Fever may be present if pyelonephritis exists or if cysts have become infected. 6. In the stage of uremia, anemia or loss of weight may be evident. Symptoms of ADPKD 1. POSITIVE FAMILY HISTORY 2.FLANK PAIN 3. HEMATURIA 4.UTI 5. VESICAL IRRITABILITY 6.COLIC 7. UREMIC SYMPTOMS

numerate disorders associated with ADPKD(AUtosmoal dominant polycystic kidney disease. 1.circle of willis berry aneurysms 2.Cysts of liver, pancreas, spleen,seminal vesicles 3.mitral valve prolapse 4.aortic root dilation 5 Aortic aneurysms 6. diverticular disease 7. insurance of renal adenoma (20%)