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Polycystic Kidney Disease (PKD)

  • What is polycystic kidney disease?

    Polycystic kidney disease

    Polycystic kidney disease (PKD) is an inherited condition characterised by the growth of cysts (sacs of fluid) on the kidneys. PKD can affect both kidneys, with cysts growing and multiplying until they constrict the healthy kidney tissues and affect kidney function. PKD can cause hypertension, kidney stones, frequent urinary tract infections and brain aneurysms (abnormal dilation of brain arteries).

    Types of polycystic kidney disease

    Autosomal dominant polycystic kidney disease

    This is a common type that is sometimes known as adult polycystic kidney disease, although children can develop it. While symptoms of adult PKD usually start to show between ages 30 and 40, some people start to experience adult PKD symptoms as a child.

    Autosomal recessive polycystic kidney disease

    Autosomal recessive polycystic kidney disease, or infantile PKD, is a rare genetic disorder affecting 1 in 20,000 children. In this type of PKD, the kidney becomes enlarged due to fluid-filled kidney cysts. This disease can be diagnosed early in life. Signs of this disease can already appear while in the womb or during the first few months of life.

  • Polycystic kidney disease is an inherited kidney disease, whereby the abnormal genes causing the disease are passed down from the parents to their offspring. In some case, a genetic mutation may occur on its own.

    Risk factors for polycystic kidney disease

    • Dominant inheritance – If your parent has the disease, the abnormal gene may be passed on to you. There is a 50% likelihood of you getting PKD.
    • Recessive inheritance – If both of your parents have the abnormal gene, they can pass this to you as recessive inheritance. With that, there is a 25% chance of you getting the disease.

    Preventing polycystic kidney disease

    Since polycystic kidney disease is an inherited disease, there is no way to prevent it. However, maintaining healthy kidneys can help prevent the complications. One way to protect the kidneys is by keeping your blood pressure in check through a healthy lifestyle. Maintain a low-salt diet with fruits, vegetables and whole grains. Likewise, do at least 30 minutes of moderate exercise most days of the week. Limit alcohol consumption and quit smoking.

  • The symptoms of PKD include:

    • Blood in the urine
    • High blood pressure
    • Pain in the back and sides
    • Upper abdominal pain associated with liver and pancreatic cysts
    • Urinary tract infections

    If you experience any symptoms of PKD, it is important to see a doctor immediately, especially if you have first-degree relatives with the disease. Early screening for this disorder is helpful in managing the condition.

  • After checking your symptoms and medical history, your doctor will require some diagnostic tests, including:

    Ultrasound

    To view your kidneys via ultrasound, a transducer will be placed on your skin and moved through the body. This noninvasive diagnostic test is used to evaluate the size, shape, and location of your kidneys.

    Computed tomography (CT scan)

    Using X-rays and computer technology, CT scan can provide images or "slices" of the body. CT scan is used to get a more detailed information about your kidneys.

    Magnetic resonance imaging (MRI)

    Without using radiation, MRI scan can create a complete image of the kidneys. Instead, it makes use of radio waves and strong magnets.

  • Treatment options are aimed at managing your symptoms and the complications associated with this disease. Depending on your existing condition, your doctor will suggest the treatment plan that suits you best. This may involve:

    Blood pressure control and management

    A blood pressure control plan can delay the development of the disease and prevent subsequent kidney damage.

    Increased fluid intake

    Increasing fluid intake to help dilute urine can help manage your condition and avoid the incidence of blood in the urine.

    Surgery to drain the cysts

    Surgery may be recommended to drain the cysts if they are causing severe pain or blocking other organs and blood vessels.

    Kidney dialysis

    If your kidneys fail to remove excess fluid and waste from the body, your doctor will recommend dialysis. Dialysis can help remove excess fluid and control high blood pressure.

    Kidney transplant

    In this procedure, a diseased kidney is replaced with a healthy kidney from either a deceased donor or from a living donor.

    Vaptans

    As part of recent developments, a new class of medications called vaptans have been developed to slow down the growth rate of cysts. Please discuss with your nephrologist to understand if this option is appropriate for you.


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  • Polycystic kidney disease may lead to several health complications, including:

    Kidney disease and failure

    Your kidneys may gradually lose their filtering ability. End-stage kidney disease that requires dialysis or a kidney transplant to sustain life may occur if kidney function deteriorates to less than 10% of normal capacity.

    Cyst in liver

    If you have polycystic kidney disease, your risk of developing liver cysts increases with age. Women are the ones that often develop bigger cysts as female hormones and multiple pregnancies are related to the development of cyst in the liver.

    Brain aneurysm

    Having PKD increases your risk of getting brain aneurysm, a balloon-like bulge in the blood vessel.

    Heart valve problems

    Polycystic kidney disease increases the risk of developing mitral valve prolapse. In this condition, the heart valve could not properly close, prompting blood to leak backward.

    Diverticulosis

    If you have polycystic kidney disease, pockets known as diverticula can develop in the walls of your digestive tract.

    Others

    Patients with polycystic kidney disease are also at greater risk for certain types of kidney stones and certain forms of kidney tumours. Your nephrologist can recognise and manage these complications.

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