POLYCYSTIC KIDNEY DISEASE: A CAUSE OF KIDNEY FAILURE

WHAT IS POLYCYSTIC KIDNEY DISEASE?

Polycystic kidney disease (also called PKD) causes numerous cysts to grow in the kidneys. These cysts are filled with fluid. If too many cysts grow or if they get too big, the kidneys can become damaged. PKD cysts can slowly replace much of the kidneys, reducing kidney function and leading to kidney failure.

WHAT ARE THE SYMPTOMS OF PKD?

Most people do not develop symptoms until they are 30 to 40 years old. The first noticeable signs and symptoms may include:

• Back or side pain
• An increase in the size of the abdomen
• Blood in the urine
• Frequent bladder or kidney infections
• High blood pressure
• Fluttering or pounding in the chest

HOW IS PKD DIAGNOSED?

Ultrasound is the most reliable, inexpensive and non-invasive way to diagnose PKD. If someone at risk for PKD is older than 40 years and has a normal ultrasound of the kidneys, he or she probably does not have PKD. Occasionally, a CT scan (computed tomography scan) and MRI (magnetic resonance imaging) may detect smaller cysts that cannot be found by an ultrasound. MRI is used to measure and monitor volume and growth of kidneys and cysts.

In some situations, genetic testing might also be done. This involves a blood test that checks for abnormal genes that cause the disease. Genetic testing can be useful when a person:

• Has an uncertain diagnosis based on imaging tests
• Has a family history of PKD and wants to donate a kidney
• Is younger than 30-years old with a family history of PKD and a negative ultrasound, and is planning to start a family

HOW IS PKD TREATED?

At present, there is no cure for PKD. However, a lot of research is being done. Recent studies suggest that drinking plain water throughout the day and avoiding caffeine in beverages can slow the growth of cysts. Research is also helping us understand the genetic basis of PKD.

In the meantime, many supportive treatments can be done to control symptoms, help slow the growth of cysts, and help prevent or slow down the loss of kidney function in people with PKD. These include:

• Careful control of blood pressure
• Prompt treatment with antibiotics of a bladder or kidney infection
• Lots of fluid when blood in the urine is first noted
• Medication to control pain (talk to your doctor about which over-the- counter medicines are safe to take if you have kidney disease)
• A healthy lifestyle with regard to smoking cessation, exercise, weight control and reduced salt intake
• Drinking lots of plain water throughout the day
• Avoiding caffeine in all beverages

ARE THERE DIFFERENT TYPES OF PKD?

Being a genetic disorder, PKD is mainly of three types, which are:

• Autosomal Dominant PKD: This form of the disease is passed from parent to child by dominant inheritance. Symptoms usually begin between the ages of 30 and 40, but they can begin earlier, even in childhood.
• Infantile or Autosomal Recessive PKD: This form of the disease is passed from parent to child by recessive inheritance. Symptoms can begin in the earliest months of life, even in the womb. It tends to be very serious, progresses rapidly, and is often fatal in the first few months of life.
• Acquired Cystic Kidney Disease: This form of disease can happen in kidneys with long- term damage and severe scarring, so it is often associated with kidney failure and dialysis. About 90 percent of people on dialysis for 5 years develop ACKD. People with ACKD usually seek help because they notice blood in their urine. This is because the cysts bleed into the urinary system, which discolours urine.

WHY KIMS?

KIMS, one of the foremost hospital for kidney disease in Hyderabad, specializes in the diagnosis and management of polycystic kidney diseases.

Our hospital in Hyderabad with world renowned kidney specialist provides a comprehensive approach to patient care with access to the hospital's range of kidney, cardiovascular, neurologic and urologic treatments and programs, including expert teams of surgeons and genetic counsellors.