Clinical Review Lesson of the week

Causes of haematuria in adult polycystic kidney disease

BMJ 2001; 323 doi: (Published 18 August 2001) Cite this as: BMJ 2001;323:386
  1. Robert Dedi, specialist registrar in nephrology (,
  2. Sunil Bhandari, consultant nephrologistc,
  3. John H Turney, consultant nephrologista,
  4. Aleck M Brownjohn, consultant nephrologista,
  5. Ian Eardley, consultant in urologyb
  1. a Department of Renal Medicine, General Infirmary at Leeds, Leeds LS1 3EX
  2. b Department of Urology, General Infirmary at Leeds
  3. c Department of Renal Medicine, Hull and East Yorkshire Hospitals NHS Trust, Hull Royal Infirmary, Hull HU3 2JZ
  1. Correspondence to: R Dedi
  • Accepted 25 May 2001

Do not assume that haematuria in association with adult polycystic kidney disease is always benign

Patients with a chronic disease may develop new, but often related, symptoms. The assumption, however, that all symptoms are related and need no further investigation, may result in the misdiagnosis of a serious disease. Autosomal dominant polycystic kidney disease is a common inherited condition, occurring in between 1 in 200 and 1 in 1000 of the population.1 After diagnosis patients are followed up by nephrologists because of the risk of progression to end stage renal failure. Renal function may be preserved, however, and outpatient attendance is often infrequent. If complications develop, affected individuals may present to primary care providers or a wide range of hospital and surgical specialties, where staff should be aware of possible diagnostic difficulties. Macroscopic haematuria is a common complication that is usually related to the polycystic kidney disease.2 We present two cases where subsequent investigations discovered bladder carcinoma and suggest possible screening methods.

Case reports

Case 1—A 49 year old man with adult polycystic kidney disease and persistent microscopic haematuria since diagnosis nine years earlier, presented with a three week history of asymptomatic macroscopic haematuria. He was otherwise well with no …

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