Polycystic Kidney Disease also known as PKD or PCKD is characterized by the growth of multiple cysts in the kidneys as a result of a genetic structural disorder of the renal tubules.
Cysts are non-functioning tubules filled with fluid pumped into them.
These cysts are microscopic or abnormal in size & destroy the neighboring healthy tubules, thereby rendering them functionless.
CLASSIFICATION OF PKD
- Autosomal dominant polycystic kidney disease (ADPKD):
a) Associated with large interfamilial & intrafamilial variability.
b) Occurs as a result in mutation of PKD1 & PKD2 genes.
- Autosomal recessive polycystic kidney disease (ARPKD):
a) Associated as a hereditary renal disease in early childhood.
b) Occurs as a result in mutation of PKHD1 gene.
SIGNS & SYMPTOMS
- High blood pressure
- Abdominal pain
- Feeling of fullness in the stomach
- Excessive urination
- Blood in the urine
- Pain in the back
- Formation of cysts in other organs.
- Subarchanoid hemorrhage
- Liver cyst
- Pancreas cyst
- Increase in RBC
- Heart valve abnormalities
- Development of inflammatory sacs in the colon
- Pregnancy & birth related abnormalities
- Urinary Tract Infections
- Kidney stones
- Chronic Kidney Disease (CKD)
- End Stage Renal disease (ESRD)
- Kidney failure.
CAUSES & RISK FACTORS OF PKD
- Genetic disorders & familial history
- Male sex
- Kidney problems
- Obstruction of the kidney.
DIAGNOSIS OF PKD
- Molecular genetic testing also called DNA analysis by linkage analysis or mutation analysis which is available as a clinical method.
- Ultrasound exam of the kidney for production of images of the kidney.
- CT scan & MRI scan for production of renal images & detecting cysts or other abnormalities.
TREATMENT & MANAGEMENT OF PKD
- Some medications that are used for treatment of PKD are:
- Aquaretic drug, like Tolvaptan which acts on the vasopressin receptor & promotes the excretion of fluid, without loss of electrolytes essential to the body.
- High blood pressure is controlled by drugs of various classes, like ACE inhibitors, CCBs, ARBII blockers etc.
- Management of pain by using opioid & non-opioid drugs.
- Some surgical methods for treatment of PKD are:
- Renal cyst aspiration, draining of the cyst by utilizing a sclerosing agent through a needle.
- Laparoscopic cyst decortication, involves removal of the cyst by implication of laparoscopic surgery.
- Neurolysis, done for pain caused due to PKD.
- Nephrectomy, surgical removal of kidneys.
- Kidney transplant
- Some management techniques are;
- Inhibition of alcohol intake & cessation of smoking that can trigger gene mutation.