Polycystic Kidney Disease
Polycystic kidney disease (PKD) is the development of clusters of spherical, fluid-filled sacs, primarily, but not exclusively, in the kidneys. As it reduces the kidney's ability to remove excess water from the bloodstream, it commonly causes high blood pressure, and may also lead to kidney failure.
PKD cysts can become extremely large. A kidney containing cysts can weigh as much as 30 pounds.
Symptoms of PKD include:
- High blood pressure
- Local pain caused by enlarged kidneys
- Bloated abdomen
- Frequent urination
- Kidney stones
- Kidney failure
- Infection of the kidney or urinary tract
Due to the kidneys' adaptability, people may have PKD for years without noticing a symptom.
PKD is caused by a genetic defect, so it runs in families. There are two types:
- Autosomal dominant polycystic kidney disease (ADPKD) often becomes apparent between the ages of 30 and 40, so it was once called adult PKD. A child with one parent with ADPKD has a 50 percent chance of inheriting the disease. About 90 percent of people with PKD have this form.
- Autosomal recessive polycystic kidney disease (ARPKD) usually appears shortly after birth, but sometimes not until adolescence. Both parents must have abnormal genes to pass ARPKD to their children; each child has a 25 percent chance of having ARPKD.
It is possible to have ADPKD with no known family history. Usually, there was an ancestor who had the disease without symptoms, but it is also possible to get ADPKD from a genetic mutation.
Diagnosis of PKD, measuring the size of the cysts, and evaluation of the damage to the kidneys is conducted by imaging, either ultrasound, computerized tomography (CT), or magnetic resonance imaging (MRI). Imaging generally results in a conclusive diagnosis.
Genetic linkage analysis compares your genes to those of relatives known to have or not to have PKD. It is often used to screen for kidney donation.
Treatment for PKD generally focuses on alleviating symptoms.
- High blood pressure can be controlled through diet, exercise, eliminating smoking, limiting alcohol and caffeine consumption, and medication. This can also slow progression of the disease and further kidney damage as it reduces kidney stress. If you have a family history of intercranial aneurysm, your WellStar physician may recommend regular screening.
- Pain associated with PKD is often mild and can be controlled with acetaminophen. In rare cases of very large cysts that create pressure and pain, they may be drained or removed.
- Obstruction of neighboring organs or blood vessels is rare and treated with surgery to drain or remove the cysts.
- Infections are treated promptly with antibiotics.
- Blood in the urine is diluted by drinking plenty of water, preventing clots in the urinary tract.
- Kidney failure eventually requires dialysis or a transplant.
Cysts associated with PKD may also appear in the liver. In rare cases, they need to be drained, affected parts of the liver may need to be removed, or a liver transplant may be required.