A Family Doctor's Tale - POLYCYSTIC KIDNEYS

DOC I HAVE POLYCYSTIC KIDNEYS

Polycystic kidneys can be inherited.

The danger is that it is progressive and may lead to kidney failure.

Most patients do not realize that they have the condition until a ultrasound or MRI of the kidneys  is done.

There may not be any symptoms  or there may be urinary infections or mild back pain.

During the investigations for urinary infection or blood in the urine, the polycystic kidneys may be detected.

Polycystic kidney disease is a progressive genetic condition of the kidneys in which multiple cysts (polycystic)are present in both kidneys.

The disease can produce cysts in the liver, pancreas, and rarely, the heart and brain.

Any one with a family history of polycystic kidneys.

There are 2 main causes of polycystic kidney disease.

Both are determined by their genetic inheritance:

1.Autosomal dominant
It is  generally a late-onset disease with progressive cyst development.

The kidneys are bilaterally enlarged and have multiple cysts.

There may be kidney dysfunction resulting in hypertension and kidney failure by the age of 60 years.

Beside this there are also cysts in other organs such as the liver, spleen, pancreas, and arachnoid mater.

Other abnormalities includes intracranial aneurysms, dissection of the aorta, mitral valve prolapse.

2.Autosomal recessive
This disease is less common than the above.


Most cases died during the pregnancy or in the first month of birth.

Early manifestations of the disease is apparent at birth or in early infancy.

Many Polycystic kidney patients do not have any symptoms.

In some cases there may be:

1.hypertension,

2.Abdominal colic due to urinary stones

3.back or flank pain

4.urinary tract infections with hematuria and proteinuria

5.Palpable large kidneys

6.Abdominal swelling

7.fatigue

8.Xrays of the kidneys on routine checkup

9.Ultrasound of the kidneys

10.MRI of the kidneys

Genetic counseling may help families at risk for polycystic kidney disease.

There is no cure for Polycystic kidney disease.

Although a cure for Polycystic kidney disease is not possible, treatment can ease the symptoms and prolong life.

1.Back Pain:
Mild pain killers such as paracetamol can relieve pain.

2.Urinary tract infections:
urinary tract infections can be treated with antibiotics.

Any urinary infection can spread from the urinary tract to the kidney cysts so early treatment is important.

Once the infection enter the cyst, treatment is difficult  because many antibiotics cannot enter the walls of the cysts.

3.High blood pressure:
All hypertensions due to Polycystic kidney disease must be kept under control with medications and lifestyle changes such as exercise, de-stressing, low salt and fats

4.Renal disease:
Eventually in all cases the kidney function will fail and chronic real failure develop.

Treatment will then be by dialysis or kidney transplant.

5.Surgery:
Surgery is rarely needed except to remove large cysts.

Even then the kidney disease is progressive and will still end in chronic renal failure.

Generally poor after the age of 60 when renal disease may set in.

The condition eventually ends in chronic renal failure with loss of kidney function.