Illustration of a polycystic human kidney. Polycystic kidney disease is one of the most common causes of chronic kidney failure in adults. This inherited condition may remain dormant & kidney function preserved until middle life. The polycystic kidney is enlarged, its surface studded with cystic swellings & underlying cysts of varying size found throughout the cortex & medulla (the internal structures of the kidney). Abdominal pain is the usual presenting symptom; diagnosis is confirmed by intravenous urography (IVU). This condition progresses to renal failure; prior to renal dialysis & trans- plantation, most patients died at 40-50 years.