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ADPKD Pei-Ravine Ultrasound Diagnostic Criteria — ESENeph MCQ

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HardPolycystic Kidney DiseaseADPKD Pei-Ravine Ultrasound Diagnostic CriteriaESENeph

A 28-year-old with an affected parent has not had genetic testing. Ultrasound shows two cysts in the left kidney and one in the right, with no alternative cystic disorder. How should this be interpreted?

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

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Correct answer: A — Three total cysts meeting the at-risk age 15–39 criterion

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

C is correct. In an at-risk person aged 15–39 from a family of unknown genotype, three or more renal cysts in total, unilateral or bilateral, meet the unified ultrasound criterion. A imports a more stringent older-age pattern. B confuses imperfect sensitivity for very mild disease with inability to diagnose a positive scan. D invents a threshold. E overstates phenotype: ultrasound does not identify the causal variant and counselling remains relevant. The criterion is applied only in the appropriate familial-risk context after excluding obvious mimics; equivocal or important donor/reproductive decisions may require higher-resolution imaging or genetic testing.

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