What complication is most likely to develop in a patient with polycystic kidney disease?

In patients with polycystic kidney disease (PKD), end-stage renal disease (ESRD) is the most likely complication to develop over time. PKD is characterized by the formation of multiple cysts in the kidneys, which gradually replace normal kidney tissue, leading to a decline in kidney function. As the disease progresses, the burden of these cysts can impair the kidneys' ability to excrete waste products and regulate fluid and electrolyte balance, culminating in kidney failure.

The genetic nature of PKD contributes to a relatively high risk of developing ESRD, particularly in those with the autosomal dominant form. It is estimated that a significant proportion of patients with this condition will require dialysis or kidney transplantation due to the progressive loss of renal function.

While intracranial aneurysms, portal hypertension, and renal carcinoma are also associated with polycystic kidney disease, they are less direct outcomes compared to the inevitable decline towards end-stage renal disease. Intracranial aneurysms have a higher prevalence in these patients, but they do not occur in all cases and are not the primary complication. Similarly, portal hypertension and renal carcinoma can occur in some individuals but are not as universally common or typical as the progression to end-stage renal disease. Thus