In autosomal dominant polycystic kidney disease (ADPKD), what is the inheritance pattern and the typical imaging finding?

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ADPKD is inherited in an autosomal dominant pattern, so a single mutated allele can give rise to the disease and affected individuals often have a family history. The imaging hallmark is numerous cysts in both kidneys, which typically makes the kidneys enlarged. Importantly, renal function can stay relatively normal early on even with many cysts, because enough healthy nephrons remain to maintain kidney function in the initial stages. Over time these cysts grow and can lead to progressive kidney failure. While liver cysts can also occur, the key imaging feature for this condition is multiple bilateral renal cysts with preserved function early in the disease.