رجل عمره ٣٩ سنة عنده ارتفاع ضغط، وأبوه توفي بفشل كلوي، وعمه على الغسيل. يشتكي ألماً في الخاصرتين ودماً في البول أحياناً. الأشعة تظهر كليتين كبيرتين فيهما أكياس كثيرة. الضغط ١٥٨/٩٨. أي إجراء مهم في متابعته؟

A 39-year-old hypertensive man’s father died of kidney failure and his uncle is on dialysis. He has flank pain and occasional haematuria; imaging shows large kidneys with many cysts. BP 158/98. What is important in his follow-up?

1. Regular surgical drainage of all the cysts every few months
2. Restricting water to shrink the cysts
3. Good BP control and genetic counselling for the family
4. Daily NSAIDs for the flank pain

Answer: C) Good BP control and genetic counselling for the family. Polycystic kidney disease is autosomal dominant. BP control slows decline, NSAIDs are avoided, adequate water is advised, relatives may need screening, and cerebral aneurysms are watched for.