This study was performed to evaluate prognostic factors in ADPKD progression to ERSF. Previously reported negative factors (male gender, age, hypertension, palpable kidneys and UTI) as well as the extra-renal presence of cysts and proteinuria, were analysed in a group of 45 ADPKD patients (Male/Female, 25/20; Age = 40.1 +/- 19.7 yrs, range 21-69). Palpable kidneys were associated with higher serum creatinine values (955 +/- 689 vs 743 +/- 504 umol/l, p < 0.001) but not with a greater prevalence of renal failure. Renal failure (100% vs 60%), higher creatinine values (981 +/- 495 vs 778 +/- 654 umol/l) and hypertension (50% vs 18%) were related to a higher prevalence of extra-renal cysts (p < 0.05). Older patients (> 40 years) had a greater prevalence of renal failure (96% vs 32%, p < 0.001). Also, subjects with palpable kidneys, and those with extra-renal cysts, were significantly older (52.8 +/- 10.3 vs 30.5 +/- 20.6 yrs, p < 0.025; and 42.1 +/- 21.9 vs 38.1 +/- 18.2 yrs, p < 0.025). Patients with renal failure and those with extra-renal cysts had a greater prevalence of proteinuria (65% vs 0%, p < 0.001; and 100% vs 24%, p < 0.001). No correlation was seen for male gender, hypertension or UTI with any known complications of ADPKD. The extrarenal presence of cysts, older age, proteinuria and palpable kidneys were associated with a worse renal outcome, but for this Romanian population we can't confirm previous reports suggesting a role for male gender and early onset of disease.