Polycystic Kidney Disease
Polycystic kidney disease (PKD) is a genetic disorder which is caused due to the formation of cysts (fluid-filled bags) on the kidneys. This leads to the loss of kidney function which may eventually lead to kidney failure. PKD is the one of the major causes of kidney failure.
Most of the patients with polycystic kidney disease do not show any symptoms for several years. Symptoms may appear once the cysts grow up to 0.5 inches or more. Initially the person may experience the following symptoms:
- Pain and discomfort in the abdomen
- Discomfort in the back and sides
- Urinary tract infection
- Frequent urination
- Pale colored skin
- Bruising of skin
- Kidney stones
Most often polycystic kidney disease is genetically inherited and is found to run in families. It may also occur due to mutations in the genes. In some cases, it can develop in people who have certain serious kidney disorders.
When to consult the doctor?
Children may show symptoms which resemble other medical problems. Therefore, they need immediate medical help if symptoms such as high blood pressure, frequent urination or urinary tract infection are noticed.
As the disease has high chances of inheritance, the doctor takes a family history of the patient. Further, the doctor may recommend a blood test to check for anemia and to detect the presence of infections. To confirm the diagnosis, the doctor may recommend imaging studies such as:
- Abdominal MRI scan which generates the images of the kidney using magnetic waves
- Abdominal ultrasound, a non-invasive technique which uses sound waves to create the images and look for the presence of cysts
- Abdominal CT scan which helps to identify small sized cysts in the kidneys
- Intravenous pyelogram which uses x-rays and dye to generate pictures of the blood vessels
Treatment can control the symptoms but cannot completely cure the disease. It is also aimed at reducing the chances of complications.
Treatment approaches for PKD include:
Management of high blood pressure – The most important step in the treatment is to control the high blood pressure. For this purpose, the doctor may prescribe medications such as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and may also suggest the patient to adopt certain lifestyle changes such as regular exercise, low sodium and low-fat diet, smoking cessation, etc.
Pain relief – The pain associated with cysts can be relieved with the use of over-the-counter medicines such as acetaminophen. However, ibuprofen should not be taken as it causes unwanted effects on the kidneys.
Urinary tract infections management – Antibiotics are prescribed to treat UTIs and prevent kidney damage.
Removal of excess fluid – Diuretics or water pills is prescribed to remove excess body fluids.
If blood is present in urine, then the doctor may immediately recommend an increase in the intake of fluids. This helps in dilution which can prevent clot formation in the urinary tract. If kidney failure has occurred in the patient with PKD, then dialysis or kidney transplantation is required to remove the wastes from the blood. Either a single or both the kidneys may be replaced. In some patients, surgery may be necessary to remove the cysts and relieve the discomfort.
If the patient with PKD has a family history of aneurysms (i.e. intracranial ruptures in blood vessels) then the patient will be asked to visit the doctor for regular screening. If aneurysm is detected, then either surgical or non-surgical treatment may be provided.
Coping and support
Presence of PKD can cause emotional impact on both the patient and the family members. Therefore, organizations which provide support and information can help in leading a better life.
The following are the complications of polycystic kidney disease:
- Formation of cysts in the other organs such as the liver, pancreas and testicles
- Kidney stones
- Kidney failure
- Liver failure
- Dangerously high blood pressure
- Cataract and blindness
- Weak areas in the walls of the arteries
- Anemia (low red blood cells)
- Certain heart problems