PKD and Kidney Cyst Infections

Approximately 30 to 50 % of patients with ADPKD will have a kidney infection at some point. An infection can occur in the lower portion of the urinary system (cystitis bladder infection) or the upper portion of the urinary system (kidney infection, actual infected cysts). Infections of the upper portion of the urinary system are less common but potentially more serious. Kidney infections in patients with ADPKD are more likely to occur in women.

The diagnosis of a kidney infection in an ADPKD patient includes a physical examination, urinalysis, and urine culture with antibiotic susceptibility testing. If actual kidney or cyst infection is suspected, a complete blood count, serum chemistries, and blood cultures may also be obtained. Patients with cyst infections frequently have pain and fever.

Since many cysts in PKD are isolated sacs, antibiotics are chosen that penetrate the cysts directly. Specific antibiotics shown to penetrate cysts include:

Fluoroquinolones such as ciprofloxacin and levofloxacin* *antibiotics of choice for treatment of cyst infections PKD patients Metronidazole Clindamycin, Ampicillin Trimethoprim-sulfamethoxazole Erythromycin Vancomycin Cefotaxime Chloramphenicol (rarely used)

Not recommended: Aminoglycosides

Physicians must choose doses based on an affected individuals kidney function. The duration of therapy will depend upon clinical response and will be determined by the treating physician. True cyst infection typically requires a longer course of therapy.

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Information provided by Dr. Benjamin Cowley, Professor of Medicine and the Chief of Nephrology and Hypertension at the University of Oklahoma Health Sciences Center