Polycystic kidney disease
What the FAA's documents say about polycystic kidney disease, in plain words, with the FAA's own words one press away.
Short version
The FAA's table sorts it into two rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AAutosomal dominant (AD-PKD) | Defers to the FAA | Special Issuance |
| Row BAutosomal recessive (AR-PKD) | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Polycystic kidney disease
- Row A · Special Issuance
Autosomal dominant polycystic kidney disease (AD-PKD). The table lists what to submit to the FAA for review -- the nephrologist's current evaluation, the medication list and side effects, recent labs, and imaging. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the pilot's own authorization letter.
A. Autosomal Dominant (AD-PKD) … Submit the following to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the airman’s authorization letter.
- Row B · Special Issuance
Autosomal recessive polycystic kidney disease (AR-PKD). The table lists what to submit to the FAA for review -- the nephrologist's current evaluation, the medication list and side effects, recent labs, and a gastroenterologist's current evaluation. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the pilot's own authorization letter.
B. Autosomal recessive (AR-PKD) … Submit the following to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the airman’s authorization letter.
The FAA pathways for polycystic kidney disease
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: The nephrologist's evaluation, medications and labs
What both rows of the table ask for.Nephrologist's current evaluation
A current evaluation from your nephrologist.
It details
- History, diagnosis and physical exam
- Current status
- Treatment plan and prognosis
- If you have hypertension, whether it is controlled
Medication list and side effects
Your medication list and side effects, if any.
Recent labs
Recent labs.
At a minimum
- Serum creatinine
- eGFR
- Spot urine protein/creatinine ratio
Show the FAA's words: The nephrologist's evaluation, medications and labs
Nephrologist current evaluation detailing: o History, diagnosis, physical exam; o Current status; o Treatment plan and prognosis; and o If airman has hypertension, the physician should comment if it is controlled.
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
Nephrologist current evaluation detailing o History, diagnosis, physical exam; o Current status; o Treatment plan and prognosis; and o If airman has hypertension, the physician should comment if it is controlled.
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
Medication list and side effects, if any;
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
Medication list and side effects if any;
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
Lab (recent) to include at a minimum: o Serum creatinine; o eGFR; and o Spot urine protein/creatinine ratio
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
Lab (recent) to include at a minimum: o Serum creatinine; o eGFR; and o spot urine protein/creatinine ratio
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
Step 2: What row A adds
Imaging, for autosomal dominant PKD.Imaging, for autosomal dominant PKD (AD-PKD).
To include
- A brain MRA (preferred), or CTA if MRI contraindications, for aneurysm
- A current transthoracic echocardiogram
Show the FAA's words: What row A adds
Imaging to include: o Brain MRA (preferred) or CTA (if MRI contraindications) for aneurysm; and o Current transthoracic echocardiogram
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
Step 3: See your AME
The table lists what to submit to the FAA for review -- the nephrologist's current evaluation, the medication list and side effects, recent labs, and imaging. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the pilot's own authorization letter.Exam day- The table lists what to submit to the FAA for review -- the nephrologist's current evaluation, the medication list and side effects, recent labs, and imaging. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the pilot's own authorization letter.
Show the FAA's words: See your AME
A. Autosomal Dominant (AD-PKD)
Submit the following to the FAA for review:
DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the airman’s authorization letter.
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
Step 4: After the FAA decides
The table says follow-up issuance will be per the pilot's own authorization letter.- The table says follow-up issuance will be per the pilot's own authorization letter.
Show the FAA's words: After the FAA decides
Follow up Issuance Will be per the airman’s authorization letter.
FAA source: Polycystic Kidney Disease. FAA date 29 July 2020; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row ADefers to the FAASpecial Issuance
The table lists what to submit to the FAA for review -- the nephrologist's current evaluation, the medication list and side effects, recent labs, and imaging. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the pilot's own authorization letter.
If the examiner defersRow BDefers to the FAASpecial Issuance
The table lists what to submit to the FAA for review -- the nephrologist's current evaluation, the medication list and side effects, recent labs, and a gastroenterologist's current evaluation. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the pilot's own authorization letter.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Special Issuance
Autosomal dominant polycystic kidney disease (AD-PKD). The table lists what to submit to the FAA for review -- the nephrologist's current evaluation, the medication list and side effects, recent labs, and imaging. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the pilot's own authorization letter.
A. Autosomal Dominant (AD-PKD) … Submit the following to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the airman’s authorization letter.
- Row B · Special Issuance
Autosomal recessive polycystic kidney disease (AR-PKD). The table lists what to submit to the FAA for review -- the nephrologist's current evaluation, the medication list and side effects, recent labs, and a gastroenterologist's current evaluation. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the pilot's own authorization letter.
B. Autosomal recessive (AR-PKD) … Submit the following to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the airman’s authorization letter.
If the examiner defersSpecial Issuance
The table marks row A, autosomal dominant (AD-PKD), DEFER.
The table marks row B, autosomal recessive (AR-PKD), DEFER.
What the FAA lists to send
- Item 1. For both rows, a nephrologist's current evaluation detailing what the table lists.
- Item 2. For both rows, the medication list and side effects, if any.
- Item 3. For both rows, recent labs, to include at a minimum serum creatinine, eGFR and a spot urine protein/creatinine ratio.
- Item 4. For row A, imaging to include a brain MRA (preferred) or CTA (if MRI contraindications) for aneurysm, and a current transthoracic echocardiogram.
- Item 5. For row B, a gastroenterologist's current evaluation detailing what the table lists.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks row A, autosomal dominant (AD-PKD), DEFER.
A. Autosomal Dominant (AD-PKD) … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 2
The table marks row B, autosomal recessive (AR-PKD), DEFER.
B. Autosomal recessive (AR-PKD) … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
For both rows, a nephrologist's current evaluation detailing what the table lists.
Nephrologist current evaluation detailing: o History, diagnosis, physical exam;
- Item 2
For both rows, the medication list and side effects, if any.
Medication list and side effects, if any;
- Item 3
For both rows, recent labs, to include at a minimum serum creatinine, eGFR and a spot urine protein/creatinine ratio.
Lab (recent) to include at a minimum: o Serum creatinine; o eGFR; and o Spot urine protein/creatinine ratio
- Item 4
For row A, imaging to include a brain MRA (preferred) or CTA (if MRI contraindications) for aneurysm, and a current transthoracic echocardiogram.
Imaging to include: o Brain MRA (preferred) or CTA (if MRI contraindications) for aneurysm; and o Current transthoracic echocardiogram
- Item 5
For row B, a gastroenterologist's current evaluation detailing what the table lists.
Gastroenterologist current evaluation detailing: o History, diagnosis, physical exam;
After the FAA decides
The table says follow-up issuance will be per the pilot's own authorization letter.
Show the FAA's words: after the FAA decides
Follow up Issuance Will be per the airman’s authorization letter.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
The nephrologist comments on hypertension
Both rows say that if the pilot has hypertension, the physician should comment on whether it is controlled.
Show the FAA's words: good to know, 1
If airman has hypertension, the physician should comment if it is controlled.
The two rows add different items
Row A, AD-PKD, adds imaging -- a brain MRA or CTA for aneurysm and a current transthoracic echocardiogram. Row B, AR-PKD, adds a gastroenterologist's current evaluation, including an abdominal ultrasound and liver function testing plus any additional testing deemed clinically indicated.
Show the FAA's words: good to know, 2
Imaging to include: o Brain MRA (preferred) or CTA (if MRI contraindications) for aneurysm; and o Current transthoracic echocardiogram … Gastroenterologist current evaluation detailing: … Abdominal ultrasound; and o Liver function testing plus any additional testing deemed clinically indicated.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
Related conditions
Each has its own page, with what the FAA's documents say about it.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.