Brief Answer: ADPKD Detailed Answer: Hi XXXX CKD stage 4 is when glomerular filtration rate ( GFR ) goes below 30 ml/min that is when serum creatinine is >2 mg/dl. It is not that the disease straight away goes to stage 4. Generally the early disease is totally asymptomatic and may have only mild hypertension and pedal oedema, so it gets noticed in advanced stage. Kidney cysts may or may not be hereditary. But since you have a history of cranial aneurysms and family history of kidney disease then it is likely to be hereditary condition called Autosomal dominant polycystic kidney disease(ADPKD). Your adult children above the age of 30 should be tested with an ultrasound, urine protein estimation and blood pressure check. If the children do not have any cyst at the age of thirty they are not likely to develop the disease in future. Best wishes.