To estimate the prevalence of autosomal dominant polycystic kidney disease (ADPKD) and provide the evaluationof new ultrasonographic criteria and clinical indicators to help its early detection. A total of 30750individuals for health check-up with abdominal ultrasonography (US) were included, in which 231 suspects of ADPKD basedon the number of renal cysts were extracted. They were divided into 4 groups by the grade of suspicion (definitive, a strongsuspect, a fair suspect and a weak suspect). Longitudinal data of US and renal function tests were compared between thegroups.The estimated prevalence rate was 0.068% from the study subjects. The level of eGFR did not differ between the definitiveand suspects, while the annual estimated glomerular filtration ratio (eGFR) decline was significantly larger in the former(p<0.001). The subjects with growing renal cysts showed a larger annual eGFR decline than those without growth (p=0.0324).The proposed cut-off set at the first quartile of the annualized eGFR change efficiently divided the subjects according to thepresence of cyst growth (p= 0.027) and the grade of suspicion of ADPKD (p=0.028). The prevalence rate ofADPKD was higher than the corresponding rate previously reported in Japan (0.025%), suggesting that health check-ups maybe an efficient opportunity to pick up undiagnosed ADPKD. The large annual eGFR decline and the presence of growing cystsmay be feasible indicators to isolate ADPKD and should be introduced into US based screening to facilitate early detectionof ADPKD.