Polycystic Kidney Disease

Polycystic Kidney Disease

Polycystic kidney disease (PKD) is a kidney disorder, which leads to clusters of fluid-filled cysts forming in the kidneys. This condition can not only impair the function of your kidneys but also eventually lead to kidney failure. It is known to be the fourth leading cause of kidney failure. The disease may cause several other complications, such as high blood pressure and cysts developing in your liver.
Polycystic kidney disease can vary in its severity. Some of the complications are preventable and proper treatment and lifestyle changes can help in reducing significant damage to your kidneys.

Symptoms

In many cases, people can live with PKD for years, without experience any signs and symptoms, which are associated with the disease. A cyst typically needs to grow half an inch or larger before you might be able to notice any symptom of the disease.

Some of the symptoms of this ailment include:

  • Blood in the urine
  • Frequent urination
  • Pain or heaviness in the back
  • Pain or tenderness in the abdomen
  • Skin that bruises easily
  • Fatigue
  • Pale skin color
  • Pain in the sides
  • Urinary tract infection
  • Kidney stones
  • Joint pain
  • Nail abnormalities

 

If you notice yourself or anyone close to you, develop any signs or symptoms of polycystic kidney disease, then it is best to see your doctor as soon as possible.

Types & Causes

Polycystic kidney disease is generally inherited. Although, in a few cases, it may develop in people having other serious kidney problems. The three main types of PKD include:

Autosomal Dominant PKD (ADPKD)- Autosomal dominant PKD, which is also termed adult PKD, accounts for around 90 percent of the cases. People having a parent with PKD has a 50 percent chance of developing this condition.

Symptoms generally occur later in life, between the ages of 30 and 40, though few people can begin to experience symptoms in childhood as well.

Autosomal Recessive PKD (ARPKD)- Autosomal Recessive PKD is much less common as compared to ADPKD. It is also inherited, but to develop ARPKD, both parents must carry the gene for the disease.

Carriers of ARPKD won’t show any symptoms if they have only one gene. However, they will have ARPKD if they inherit two genes from each parent. Four types of ARPKD exist, which include:

  • Prenatal form, which is present at birth.
  • Neonatal form can occur within the first month after birth.
  • Infantile form can occur when a child is 3 to 12 months old.
  • Juvenile form can occur after a child is 1 year old.

 

Acquired cystic kidney disease- Acquired cystic kidney disease (ACKD) is not inherited and it generally occurs at a later stage in life.

This condition is generally seen in people who are already having other kidney problems. It is more common among people having kidney failure and people who are on dialysis.

Diagnosis

Since ADPKD and ARPKD are inherited, the doctor will first need to review your family history. They might initially need to order a complete blood count in order to look for anemia or any other signs of infections.

To diagnose all three types of PKD, your doctor can use imaging tests to look for cysts of the kidney, liver, and other organs. Imaging tests that are used to diagnose PKD include:

Abdominal Ultrasound

This noninvasive test makes use of sound waves to look at the kidneys for cysts.

Abdominal CT scan

This test is able to detect smaller cysts in the kidney.

Abdominal MRI scan

This MRI uses strong magnets to image your body to visualize kidney structure and look for any cysts.

Intravenous Pyelogram

This test uses a dye to make your blood vessels show up more clearly on an X-ray.

Treatment

The severity of this condition can vary from person to person, even among the members of the same family. Generally, treating polycystic kidney diseases involves treating the signs, symptoms, and complications in the early stages.

Kidney Cyst Growth

Medications such as Tolvaptan may be recommended for adults who are at risk of rapidly progressive ADPKD to stop the growth of cysts in their kidneys.

Pain

Over-the-counter medications might help you to control the pain of polycystic kidney disease. However, the pain is more severe and constant in some people.

Declining Kidney Function

To help the kidneys function better, experts generally recommend maintaining normal body weight. Drinking water and fluids throughout the day can also help in the slowing of the growth of the cysts. If you follow a low-salt diet and eat less protein, it might allow kidney cysts to respond better to the increase in fluids.

High blood pressure

If the high blood pressure is controlled, it can help to delay the progression of the disease and slow further kidney damage. You can go for a low-sodium, low-fat diet that’s moderate in protein and calorie content, and also stop smoking, increase exercise as well as reduce stress. Your doctor might also recommend certain medications to help you control your high blood pressure.

Blood in the urine

It is important to drink lots of fluids, preferably plain water, as soon as you notice blood in your urine, as this will help in diluting the urine. Dilution might also help to prevent obstructive clots from forming in your urinary tract. In most cases, the bleeding should stop on its own. However, if it doesn’t, it is best to contact your doctor.

Bladder or kidney infections

Prompt treatment of infections with antibiotics is extremely important to prevent kidney damage. Your doctor will likely investigate whether you are having a simple bladder infection or a more complicated cyst or kidney infection. A longer course of antibiotics is generally required for more complicated infections.

Kidney failure

If your kidneys stop functioning and lose their ability to remove the waste products and extra fluids from your blood, then a transplant or dialysis is going to be required.

Aneurysms

If you are suffering from polycystic kidney disease and a family history of ruptured brain aneurysms, then your doctor might recommend regular screening for intracranial aneurysms.

If an aneurysm is discovered, then surgical clipping of the aneurysm to reduce the risk of bleeding may be an option, depending on its size. There are non-surgical treatment options as well, such as controlling high blood pressure, and high blood cholesterol. Quitting smoking is also quite beneficial.

Complications

Several complications are associated with polycystic kidney disease. They include the following:

High blood pressure- A common complication of polycystic kidney disease is elevated blood pressure. If high blood pressure is untreated, it can cause further damage to your kidneys and may increase the risk of heart disease or stroke.

Chronic pain- Pain is another common symptom among people with polycystic kidney disease. It generally occurs in your side or back. It is also possible that the pain is associated with a urinary tract infection, a kidney stone, or a malignancy.

Loss of kidney function- A progressive loss of kidney function is known to be one of the most serious complications of polycystic kidney disease. Nearly half of the patients suffering from PKD have kidney failure by the age of 60.

This happens because PKD can interfere with your kidneys’ ability to keep wastes from building to toxic levels. As the disease worsens, end-stage kidney disease may occur, which can require you to undergo dialysis or a transplant.

Growth of cysts in the liver- If you are having polycystic kidney disease, then you are more likely to develop liver cysts, as your age increases. While both men and women develop cysts, cysts in women are often larger. Female hormones and multiple pregnancies can also contribute to liver cysts.

Heart valve abnormalities- Around 25 percent of adults with polycystic kidney disease develop mitral valve prolapse. When this happens, the heart valve no longer closes properly, and this can allow blood to leak backward.

Development of an aneurysm in the brain- A balloon-like bulge in a blood vessel in your brain can cause bleeding i.e. hemorrhage if it ruptures. People suffering from polycystic kidney disease usually have a higher risk of aneurysms. People with a family history of aneurysms are at the highest risk. You can talk to your doctor to ask if screening is needed in your case.

Pregnancy complications- Most women having polycystic kidney disease are generally able to have a successful pregnancy. However, in some cases, women can develop preeclampsia, a life-threatening disorder. Those having high blood pressure or a decline in kidney function are more likely to develop it.

Colon problems- Weaknesses and pouches or sacs in the wall of the colon i.e. diverticulosis can also develop in people who are having polycystic kidney disease.

Prevention

One of the best ways to prevent some of the complications of PKD is to keep your kidneys as healthy as you can.

Some of the tips to keep your blood pressure in check include eating a diet low in salt, and containing plenty of fruits and vegetables, exercising regularly and maintaining a healthy weight, quitting smoking, and reducing alcohol consumption.

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