Polycystic kidney disease diagnostic study of choice: Difference between revisions

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__NOTOC__
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{{Polycystic kidney disease}}
{{Polycystic kidney disease}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}} {{MKA}}
== Overview ==
== Overview ==
The diagnostic study of choice for polycystic kidney disease is ultrasound. Findings on an ultrasound diagnostic of polycystic kidney disease include, atleast three unilateral or bilateral [[cysts]] in patients 15 - 39 years old, atleast two [[cysts]] in each [[kidney]] in patients 40 - 59 years old, atleast four [[cysts]] in each [[kidney]] in patients 60 years of age or older.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==


=== Study of choice ===
=== Study of choice ===
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
The diagnostic study of choice for polycystic kidney disease is ultrasound.


OR
===== Diagnostic results =====
 
The following finding(s) on performing renal ultrasound are confirmatory for ADPKD:
The following result of [gold standard test] is confirmatory of [disease name]:
*Atleast three unilateral or bilateral [[cysts]] in patients 15 - 39 years old
* [Result 1]
*Atleast two [[cysts]] in each [[kidney]] in patients 40 - 59 years old
* [Result 2]
*Atleast four [[cysts]] in each [[kidney]] in patients 60 years of age or older
 
OR
 
[Name of the investigation] must be performed when:
* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
 
OR
 
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
 
OR
 
The diagnostic study of choice for [disease name] is [name of the investigation].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
 
OR
 
[Disease name] is primarily diagnosed based on the clinical presentation.
 
OR


Investigations:
Note:  
* Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
*[[Ultrasonography]] is the preferred tool for the diagnosis of ADPKD due to its safety profile and low cost.  
* Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
*In patients with a positive family history, the diagnosis of ADPKD is based on the detection of bilateral fluid-filled [[renal]] [[cysts]].  
* Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
*Ultrasound imaging is highly sensitive and can detect [[cysts]] > 1 cm in diameter.<ref name="pmid16310571‎">{{cite journal| author=O'Neill WC, Robbin ML, Bae KT, Grantham JJ, Chapman AB, Guay-Woodford LM et al.| title=Sonographic assessment of the severity and progression of autosomal dominant polycystic kidney disease: the Consortium of Renal Imaging Studies in Polycystic Kidney Disease (CRISP). | journal=Am J Kidney Dis | year= 2005 | volume= 46 | issue= 6 | pages= 1058-64 | pmid=16310571‎ | doi=10.1053/j.ajkd.2005.08.026 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16310571  }} </ref>
 
==== The comparison of various diagnostic studies for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|}
<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
 
===== Diagnostic results =====
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
* [Finding 1]
* [Finding 2]


===== Sequence of Diagnostic Studies =====
===== Sequence of Diagnostic Studies =====
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=== Diagnostic Criteria ===
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
According to the KDIGO guidelines and the unified criteria for ultasonographic assessment the following findings are diagnostic of ADPKD:<ref name="pmid25786098">{{cite journal |vauthors=Chapman AB, Devuyst O, Eckardt KU, Gansevoort RT, Harris T, Horie S, Kasiske BL, Odland D, Pei Y, Perrone RD, Pirson Y, Schrier RW, Torra R, Torres VE, Watnick T, Wheeler DC |title=Autosomal-dominant polycystic kidney disease (ADPKD): executive summary from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference |journal=Kidney Int. |volume=88 |issue=1 |pages=17–27 |date=July 2015 |pmid=25786098 |pmc=4913350 |doi=10.1038/ki.2015.59 |url=}}</ref><ref name="pmid18945943">{{cite journal |vauthors=Pei Y, Obaji J, Dupuis A, Paterson AD, Magistroni R, Dicks E, Parfrey P, Cramer B, Coto E, Torra R, San Millan JL, Gibson R, Breuning M, Peters D, Ravine D |title=Unified criteria for ultrasonographic diagnosis of ADPKD |journal=J. Am. Soc. Nephrol. |volume=20 |issue=1 |pages=205–12 |date=January 2009 |pmid=18945943 |pmc=2615723 |doi=10.1681/ASN.2008050507 |url=}}</ref>
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Atleast three unilateral or bilateral [[cysts]] in patients 15 - 39 years old
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Atleast two [[cysts]] in each [[kidney]] in patients 40 - 59 years old
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Atleast four [[cysts]] in each [[kidney]] in patients 60 years of age or older
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
** Criteria 1
** Criteria 2
** Criteria 3
 
IF there are clear, established diagnostic criteria:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].


==References==
==References==
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{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Up-To-Date]]
[[Category:Primary care]]
[[Category:Medicine]]
[[Category:Nephrology]]
[[Category:Radiology]]

Revision as of 22:46, 5 June 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]

Overview

The diagnostic study of choice for polycystic kidney disease is ultrasound. Findings on an ultrasound diagnostic of polycystic kidney disease include, atleast three unilateral or bilateral cysts in patients 15 - 39 years old, atleast two cysts in each kidney in patients 40 - 59 years old, atleast four cysts in each kidney in patients 60 years of age or older.

Diagnostic Study of Choice

Study of choice

The diagnostic study of choice for polycystic kidney disease is ultrasound.

Diagnostic results

The following finding(s) on performing renal ultrasound are confirmatory for ADPKD:

  • Atleast three unilateral or bilateral cysts in patients 15 - 39 years old
  • Atleast two cysts in each kidney in patients 40 - 59 years old
  • Atleast four cysts in each kidney in patients 60 years of age or older

Note:

  • Ultrasonography is the preferred tool for the diagnosis of ADPKD due to its safety profile and low cost.
  • In patients with a positive family history, the diagnosis of ADPKD is based on the detection of bilateral fluid-filled renal cysts.
  • Ultrasound imaging is highly sensitive and can detect cysts > 1 cm in diameter.[1]
Sequence of Diagnostic Studies

The [name of investigation] should be performed when:

  • The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
  • A positive [test] is detected in the patient, to confirm the diagnosis.

Diagnostic Criteria

According to the KDIGO guidelines and the unified criteria for ultasonographic assessment the following findings are diagnostic of ADPKD:[2][3]

  • Atleast three unilateral or bilateral cysts in patients 15 - 39 years old
  • Atleast two cysts in each kidney in patients 40 - 59 years old
  • Atleast four cysts in each kidney in patients 60 years of age or older

References

  1. ↑ O'Neill WC, Robbin ML, Bae KT, Grantham JJ, Chapman AB, Guay-Woodford LM; et al. (2005). "Sonographic assessment of the severity and progression of autosomal dominant polycystic kidney disease: the Consortium of Renal Imaging Studies in Polycystic Kidney Disease (CRISP)". Am J Kidney Dis. 46 (6): 1058–64. doi:10.1053/j.ajkd.2005.08.026. PMID 16310571‎ Check |pmid= value (help).
  2. ↑ Chapman AB, Devuyst O, Eckardt KU, Gansevoort RT, Harris T, Horie S, Kasiske BL, Odland D, Pei Y, Perrone RD, Pirson Y, Schrier RW, Torra R, Torres VE, Watnick T, Wheeler DC (July 2015). "Autosomal-dominant polycystic kidney disease (ADPKD): executive summary from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference". Kidney Int. 88 (1): 17–27. doi:10.1038/ki.2015.59. PMC 4913350. PMID 25786098.
  3. ↑ Pei Y, Obaji J, Dupuis A, Paterson AD, Magistroni R, Dicks E, Parfrey P, Cramer B, Coto E, Torra R, San Millan JL, Gibson R, Breuning M, Peters D, Ravine D (January 2009). "Unified criteria for ultrasonographic diagnosis of ADPKD". J. Am. Soc. Nephrol. 20 (1): 205–12. doi:10.1681/ASN.2008050507. PMC 2615723. PMID 18945943.

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