Background: Autosomal Dominant Polycystic kidney disease (ADPKD) is the most common hereditary cause of End stage renal disease (ESRD). Urinary tract Infections (UTI) are common in these patients and include a spectrum of both Lower tract and upper tract UTI.

Methods: This retrospective study which included patients of ADPKD who manifested UTI between June 2012 to May 2017. Clinical, Laboratory, imaging and microbiological data was analyzed. Few patients had more than one episode of UTI and there by the total number of UTI episodes were 52.Out of the 58 episodes of UTI, Lower tract UTI and Upper tract UTIs were 13 and 45 episodes. Among the total 45 episodes of upper UTI, 17 were Acute Pyelonephritis and 28 were Cyst infections. 40 % of UTI episodes necessitated Hospitalization.

Conclusions: Cyst infection is the most common form of UTI followed by acute pyelonephritis and Lower tract UTI. Majority of the UTI episodes were caused by E.coli. Around 40 % of patients with UTI mandated hospitalization but no episode of death attributable to UTI was noted.

Keywords: Autosomal dominant polycystic kidney disease (ADPKD), Urinary Tract infection (UTI), Acute Pyelonephritis, Cyst infection, Extra renal manifestations.

1. Patel, Vishal; Chowdhury, Renuka; Igarashi P. Advances in the Pathogenesis and Treatment of Polycystic Kidney Disease. Curr Opin Nephrol Hypertens. 2010;18(2):1-12. doi:10.1097/MNH.0b013e3283262ab0
2. Ong ACM, Devuyst O, Knebelmann B, Walz G. Autosomal dominant polycystic kidney disease: The changing face of clinical management. Lancet. 2015;385(9981):1993-2002. doi:10.1016/S0140-6736(15)60907-2
3. Igarashi P, Somlo S. Genetics and pathogenesis of polycystic kidney disease. J Am Soc Nephrol. 2002;13(9):2384-2398. doi:10.1097/01.ASN.0000028643.17901.42
4. Sallée M, Rafat C, Zahar JR, et al. Cyst infections in patients with autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. 2009;4(7):1183-1189. doi:10.2215/CJN.01870309
5. Fick GM, Johnson AM, Hammond WS, Gabow PA. Causes of death in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 1995;5(12):2048-2056. http://cod.
6. Rahman E, Niaz FA, Al-suwaida A, et al. Polycystic Kidney Disease : A Single Center Study. Nephrology. 2009;20(5): 806-810.
7. Hwang JH, Park HC, Jeong JC, et al. Chronic asymptomatic pyuria precedes overt urinary tract infection and deterioration of renal function in autosomal dominant polycystic kidney disease. BMC Nephrol. 2013;14(1):1-9. doi:10.1186/1471-2369-14-1
8. Sklar AH, Caruana RJ, Lammers JE, Strauser GD. Renal infections in autosomal dominant polycystic kidney disease. Am J Kidney Dis. 1987;10(2):81-88.
9. Keenan D, Maxwell AP. Optimising the management of polycystic kidney disease. Practitioner. 2016;260(1790):2,13-16.
10. SCHRIER TE and RW. Hypertension in Autosomal-Dominant Polycystic Kidney Disease: Early Occurrence and Unique Aspects. J Am Soc Nephrol. 2001;12(1):194-200. doi:10.1037/h0046469
11. Tkachenko O, Helal I, Shchekochikhin D, Schrier RW. Renin-angiotensin-aldosterone system in autosomal dominant polycystic kidney disease. Curr Hypertens Rev. 2013;9(1):12-20. doi:10.2174/1573402111309010003
12. Kamboj M, Zeng X, Koratala A. Renal cyst infection: a diagnostic dilemma. Clin case reports. 2018;6(4):762-763. doi:10.1002/ccr3.1441
13. Jouret F, Lhommel R, Devuyst O, et al. Diagnosis of cyst infection in patients with autosomal dominant polycystic kidney disease: Attributes and limitations of the current modalities. Nephrol Dial Transplant. 2012;27(10):3746-3751. doi:10.1093/ndt/gfs352
14. Grantham JJ. The etiology, pathogenesis, and treatment of autosomal dominant polycystic kidney disease: Recent advances. Am J Kidney Dis. 1996;28(6): 788-803. doi:10.1016/S0272-6386(96)90378-9
15. Rizk D, Chapman AB. Cystic and inherited kidney diseases. Am J Kidney Dis. 2003;42(6):1305-1317.
16. Irazabal M V., Torres VE. Complications of polycystic kidney disease. Polycystic Kidney Dis From Bench to Bedside. 2015;51(1):149-163. doi:10.2217/EBO.12.123
17. AB C. Intracranial aneurysms in autosomal dominant polycystic kidney disease. N Engl J Med. 1992;327(13):916-920. doi:10.1056.

Dr P Sharmas Vali

Associate Professor, Dept of Nephrology, Osmania General Hospital, Hyderabad-35, Telangana, India

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