Weekly issue 2026-W40 ·
Autosomal dominant polycystic kidney disease in children and adolescents
Plain language
ADPKD is usually thought of as an adult disease, but cysts often start before birth. Most children with ADPKD feel well, yet 20–40% have high blood pressure, and some leak protein in their urine. Both can be treated early. This review recommends regular blood-pressure checks, blood-pressure medicines when needed, less salt and good hydration. Ultrasound is the usual test, with genetic testing for very early or unusual cases.
Clinical note
Narrative paediatric review. Cystogenesis often begins in utero; most children asymptomatic, but hypertension in 20–40% and albuminuria are early, treatable markers of long-term prognosis. Ultrasound is first-line; genetic testing for very-early-onset or atypical presentations. Management centres on strict BP control with RAS inhibitors plus sodium restriction and adequate hydration. Supports routine BP and albuminuria monitoring in at-risk children; no paediatric disease-modifying therapy is established.
Question for your next visit
Should my child, who may have inherited ADPKD, have regular blood-pressure and urine checks, and from what age?