A nurse is caring for a 32-year-old client who has newly diagnosed polycystic kidney disease (PKD). Which of the following findings should the nurse expect?

Polycystic kidney disease is a genetic disorder characterized by the growth of numerous cysts in the kidneys. These cysts fill with fluid, causing massive enlargement of the organs and potential compression of surrounding tissues, which leads to chronic pain and a progressive decline in functional nephron capacity over several decades. Shutterstock Explore A. Confusion is not a typical finding in the early stages of polycystic kidney disease. While neurological changes can occur in end-stage renal disease due to the accumulation of uremic toxins (uremic encephalopathy), a 32-year-old newly diagnosed client would unlikely present with significant cognitive impairment unless they were in acute renal crisis. B. Flank pain is the most common early symptom of polycystic kidney disease. It results from the physical enlargement of the kidneys as cysts expand, stretching the renal capsule. Pain can also be caused by secondary complications such as cyst rupture, internal hemorrhage into a cyst, or the development of nephrolithiasis. C. Hypotension is not expected in polycystic kidney disease; in fact, hypertension is one of the earliest and most consistent signs. The compression of renal vessels by expanding cysts triggers the renin-angiotensin-aldosterone system, causing systemic vasoconstriction and fluid retention, which elevates blood pressure significantly in about 50% to 75% of patients. D. Urinary retention, or the inability to empty the bladder, is not a primary manifestation of polycystic kidney disease. PKD affects the renal parenchyma rather than the lower urinary tract or bladder outlet. While patients may experience frequency or urgency due to cyst pressure or infection, the mechanical retention of urine is not expected.