Hemorrhage into cysts in ADPKD is managed with which approach?

• A. Surgical drainage
• B. Anticoagulation
• C. Best rest and fluids
• D. Immediate nephrectomy

Answer: (C)

Hemorrhage into cysts in ADPKD is typically managed with supportive, conservative care because bleeding from cysts is usually self-limited and the body can reabsorb the blood over time. The main approach focuses on bed rest and adequate hydration to maintain renal perfusion and help stabilize the patient, along with proper pain control. Monitoring helps detect ongoing bleeding or anemia and guides further care.

Anticoagulation would worsen bleeding, so it’s avoided during an active hemorrhagic cyst episode. Surgical drainage is not the standard initial step for most hemorrhagic cysts, since bleeding often resolves without intervention. Nephrectomy is reserved for rare, extreme cases such as nonfunctioning kidneys, severe infection, or other complicating factors, not for routine hemorrhagic cysts.