Monocyte and macrophage markers are among the most highly overexpressed genes in cpk mouse kidneys with severely progressive renal cystic disease. We now demonstrate that one of these markers, CD14, is abnormally transcribed, activated and shed in cystic kidneys. However, these abnormalities are not associated with an increased number of interstitial CD14-positive mononuclear cells. Instead, we show that most non-cystic and cystic renal tubular epithelia are CD14-positive and that CD14 can be produced even by distal nephron-derived principal cells. Cd14 overexpression is significant in as early as 5-d old sporadically cystic cpk kidneys and it further increases during the disease progression. Similarly, in a cpk model with variable rates of cystic kidney disease progression, a (C57BL/6J-cpk × CAST/Ei)F1 intercross, Cd14 expression positively correlates with kidney volume in 10-d old mice, exceeding the correlation of a gene encoding an established autosomal dominant polycystic kidney disease (ADPKD) marker, MCP-1 (r=0.94 vs. r=0.79; both p<0.001). Similarly, in a small group of ADPKD patients (n=16), baseline urinary CD14 levels (but not GFR) correlate with a two-year rate of total kidney volume change (overall r=0.43, p=0.09; for males r=0.74, p=0.02) suggesting potential utility of CD14 in predicting ADPKD outcomes.