Polycystic Kidney Disease, Adult

Polycystic kidney disease (PKD) is a disease in which the kidneys grow many small cysts filled with fluid. These cysts hurt the working (function) of the kidneys by growing so much they squeeze the normal kidney tissue that is still working correctly. Usually with PKD kidneys work normally until adulthood. There is often progressive (continuous) loss of kidney function and also development of high blood pressure (hypertension). At times bleeding from a cyst may cause pain in the middle and side of your back, below your ribs. Kidney stones are also common. In milder forms of the disease, most of the renal (kidney) function may be adequate throughout life.

The following problems are some of the most common in polycystic kidney disease:

  • High blood pressure (hypertension).

  • Anemia (you don't have enough healthy red blood cells to carry adequate oxygen to your tissues).

  • Flank Pain (pain in middle and side of back below ribs).

  • Blood in the urine.

  • Kidney failure.

  • Kidney stones.

  • Increased urination at night.

  • Liver disease and liver cysts.

DIAGNOSIS

Often kidney disease may be suspected by your attending caregiver from history (asking what is wrong) and physical exam (he or she checks you over). In the adult this often occurs after one of the problems listed above shows up. Then, studies such as ultrasound, CT scan or an MRI scan may be done. The CT and MRI are specialized X-rays which help your caregiver be more sure about what is going on. Sometimes chromosome studies are done to see if you have the genes necessary to have polycystic kidneys. Sometimes other members of the family will also be studied to see if future treatment may be needed or if closer follow up is necessary for one of the family members.

TREATMENT

  • There is no treatment at this time to keep the cysts from forming or getting larger.

  • Medications are available to treat the high blood pressure and this is done to slow down further damage to the kidneys.

  • All infections must be treated immediately.

  • Sometimes cysts need to be drained with a needle or trochar if they are large and causing pressure on other organs and further destroying kidney tissue. This may at times require surgery.

  • Often kidney failure does not occur until middle age and then dialysis or transplantation is used to treat the illness. Most transplant patients live relatively long and normal lives with proper treatment.