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ADPKD Screening — ESENeph MCQ

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HardPolycystic Kidney DiseaseADPKD ScreeningESENeph

An asymptomatic 18-year-old whose father has ADPKD asks for renal ultrasound because she may later donate a kidney and is concerned about insurance and reproductive implications. What should happen first?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Counselling and shared decision-making before diagnostic testing

Explanation lettering: C = shown as A · E = shown as C · A = shown as D · D = shown as E

D is correct. Predictive testing in an adult relative is voluntary and should follow counselling about the limits of ultrasound at younger ages, possible genetic testing, donor implications, reproductive choices and psychosocial or financial consequences. A adds radiation and contrast without a first-line indication. B denies useful evaluation and informed choice. C turns one diagnostic route into a compulsory test. E overstates the exclusion value of a negative young-adult ultrasound, particularly in milder genotypes. The eventual test depends on family genotype, age, purpose and the degree of diagnostic certainty required.

Reference: KDIGO 2025 guideline for ADPKD: https://kdigo.org/wp-content/uploads/2025/01/KDIGO-2025-ADPKD-Guideline.pdf