end-stage renal disease will occur in up to 50$ of patients by 60 years of age. There is great variability in the age of onset of renal failure (2 years to 80 years).
renal disease appears to have a less aggressive course in women.
hypertension is also associated with a more aggressive course.
predictors of more rapid progression to renal failure include the following:
earlier age at diagnosis
male sex
sickle cell trait
PKD1 genotype
larger or rapidly increasing kidney size
gross hematuria
hypertension
being black
increasing proteinuria
most lethal extrarenal manifestations of ADPKD are intracranial aneurysms, which has been found to be present in up to 40% of ADPKD patients
these aneurysms can rupture, causing intracranial hemorrhage and death in 8% to 11% of patients
risk for renal cancer in ADPKD with renal failure
incidence of clinically significant renal cell carcinoma (RCC) in ADPKD patients with renal failure is not increased as compared to patients with other kidney diseases, although in some studies removed ADPKD kidneys revealed a 5% to 8% incidence of RCC, most measuring <=2 cm in diameter
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