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ADPKD Cyst Rupture — ESENeph MCQ

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EasyPolycystic Kidney DiseaseADPKD Cyst RuptureESENeph

A 40-year-old man with ADPKD and eGFR 40 develops new severe flank pain. CT shows a 3 cm simple cyst has ruptured. There is no infection or haemorrhage. What is the management?

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Correct answer: D — Conservative: analgesia (avoiding NSAIDs), rest, hydration – most ruptured cysts resolve spontaneously

Simple cyst rupture in ADPKD is usually self-limiting. Management is conservative with appropriate analgesia (avoiding NSAIDs in CKD), rest, and hydration. Pain typically resolves within days. Intervention is only needed for complications: ongoing haemorrhage (embolisation), infection (antibiotics ± drainage), or persistent symptoms. CT helps exclude these complications. Tolvaptan reduces cyst growth over time but is not a treatment for acute cyst rupture.

Reference: Chapman et al 2015 – ADPKD Management