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Polycystic kidney disease

Polycystic kidney disease

Polycystic kidney disease is a serious disease associated with changes in the kidney tissue, which becomes presented in the form of a large number of cysts. A factor in the development of polycystic kidney disease is a hereditary factor (the risk of developing the disease is transmitted from parents to children). This disease affects only both kidneys (cases of polycystic lesion of one kidney while maintaining normal renal tissue in the other is unknown).

The characteristic signs of polycystic disease are dull pain in the lower back, rapid fatigability of a person. The presence of anemia and polyuria is also characteristic. Blood pressure in a patient with polycystic kidney disease is increased.

The risk of developing polycystic disease is the same for the male population, and for the female. It is not so easy to recover from polycystic kidney disease, since there are not so many effective remedies for diseases that are hereditary in nature.

Treatment often focuses on preventing complications and treating them. Surgical treatment is possible. Polycystic kidney disease can be accompanied by other diseases (for example, polycystic liver disease), and can also lead to the development of pyelonephritis.

Polycystic kidney disease is a common disease among the population. Indeed, this disease is not very rare in our time. But polycystic disease cannot be called a widespread disease. This is due to the fact that polycystic kidney disease can develop in a person only if there is a genetic predisposition to it.

Polycystic kidney disease is hereditary. Science has known this for a long time. Indeed, a predisposition to the development of polycystic kidney disease is genetically transmitted. Situations are frequent when polycystic kidney disease is detected either in all family members, or in several (that is, we are talking about not isolated cases of polycystic kidney disease in the family). When a child is born (if the parents are sick with this disease), his kidneys already have the rudiments of cysts. Based on the above, it can be argued that polycystic kidney disease is a congenital disease.

Polycystic disease affects both kidneys. Polycystic kidney disease is always a bilateral disease. Polycystic disease leads to the fact that the kidney tissue becomes presented in the form of multiple cysts (hence the name - polycystic, poly - means a lot). All of these cysts can be of different sizes. The very appearance of cysts is directly related to abnormalities in the formation of renal tubules - as a result, it may turn out that some of the renal tubules end blindly. The latter leads to the fact that these tubules are completely filled with urine (it cannot be excreted, because normally the renal tubules flow into the collecting ducts, from which urine through the small and large renal cups enters the ureters and is excreted from the body). After some time, bubbles form in such renal tubules (this is caused by the accumulation of urine in the renal tubule, which does not communicate with other structures of the kidney). These blisters are cysts. Often a polycystic altered kidney is compared to a bunch of grapes (there really is something similar).

Polycystic kidney disease is a chronic disease. It really is. Throughout a person's life, polycystic kidney disease gradually progresses in its development. The disease manifests itself, as a rule, between the ages of twenty and forty. It is during this period of life that it is easiest to diagnose it. There are cases when the diagnosis of polycystic kidney disease is made both in childhood and in old age.
Polycystic kidney disease progresses throughout life, most often reveals itself and is diagnosed at the age of 20-40 years. However, this disease can reveal itself both in childhood and in old age.

Polycystic kidney disease leads to cysts in other organs. Not so much contributes as it is accompanied and not always - often cysts are formed only in the kidneys. Polycystic kidney disease often develops in parallel with polycystic liver disease.

Dull pains are characteristic of polycystic kidney disease. They are localized in the lumbar region. A patient with polycystic kidney disease is quickly overworked, especially during physical exertion. Polycystic disease is also characterized by frequent thirst and polyuria. Polyuria is frequent urination (which is also copious). Polycystic kidney disease leads to the development of renal failure in the patient. The patient often has cardiovascular disorders. On the basis of polycystic disease, pyelonephritis often develops, since the infection spreads in the kidney affected by cysts.

Polycystic kidney disease is classified into two types. Each of them is due to genetic defects. The first type is autosomal dominant. With him, the signs of polycystic kidney disease reveal themselves, as a rule, between thirty and forty years - that is why earlier the autosomal dominant type of polycystic kidney disease was called polycystic kidney disease in adults (but cases of the development of this type of polycystic kidney disease are also found among the child population). This type of polycystic disease occurs more often - namely in 85 -90% of cases. The risk of developing an autosomal dominant type of polycystic kidney disease is transmitted to the child even if one of the parents is sick with polycystic kidney disease.
The second type is autosomal recessive polycystic kidney disease. This type of disease is much less common and is associated with the detection of signs of the disease, as a rule, soon after the birth of a child (however, polycystic kidney disease in this case can be diagnosed in adolescence. In contrast to the autosomal dominant type of polycystic disease, a child can this disease is transmitted from parents only if both parents have a genetic defect (the probability of a child's disease with polycystic disease is 25%).
Science knows two genes that are responsible for the development of the first type of polycystic disease (autosomal dominant), as well as one gene responsible for the development of the second type of polycystic disease (autosomal recessive).

There are three stages of polycystic kidney disease. They are allocated based on how quickly chronic kidney failure progresses.
The first stage is associated with a situation where the existing renal failure can be compensated by the capabilities of the human body. This stage of polycystic kidney disease is characterized by the presence of dull aching pains in the patient, which are located in the region of the kidneys and lower back. Also, the patient feels a general weakness in the body - he gets tired quickly, he has headaches from time to time. The work of the kidneys itself is very slightly impaired.
The second stage of polycystic kidney disease also has a second name - the stage of subcompensation. It is associated with the process of a gradual decrease in the replenishing capabilities of the human body. Common signs of this stage are nausea, thirst, and dry mouth, increased blood pressure, and headaches.
The third stage of polycystic kidney disease is a stage of decompensation. It is characterized by the presence of incessant nausea and vomiting, a strong constant feeling of thirst. The general condition of the patient in this case worsens. The functionality of the kidneys is impaired - as a result of the fact that the kidneys cannot perform their functions in a normal volume (and the main function of the kidneys is the selective removal of various substances that cannot be used in the human body), the blood of a patient with polycystic disease contains a considerable amount of metabolic products. Metabolic products, for example, include creatinine, urea, etc. That is, the kidneys are not able to remove these metabolic products from the body.

The patient's complaints serve as the basis for diagnosing polycystic kidney disease. A mandatory moment in the diagnosis is the examination of the patient by a specialist. Enlarged kidneys (the contours of which are also uneven due to the development of the disease) are easily felt through the anterior abdominal wall; there are even cases when the kidneys are not just enlarged in size, but enlarged very much, and therefore they can be detected even without palpating the patient - they are visible, one might say, with the naked eye (enlarged kidneys protrude through the walls of the patient's abdomen). The latter situation is more common in children than in adults.
In case of polycystic kidney disease, a urine test is performed, which in case of this disease reveals the presence of leukocytes and erythrocytes in the urine (which are blood cells). The specific gravity of urine is constant during the day and is reduced.
Laboratory blood test data are also important. With polycystic kidney disease, a blood test will reveal anemia in the patient. Anemia is a decrease in the number of red blood cells - red blood cells in the blood. A biochemical analysis of the blood of a patient with polycystic kidney disease shows an increase in the amount of creatinine and urea.
Ultrasound examination confirms the results of palpation - ultrasound makes it possible to determine the increase in kidney size due to the presence of a large number of cysts in the renal tissue. In addition, excretory urograms show that in a patient with polycystic the renal pelvis is deformed and stretched. The reason for this is the squeezing of the pelvis with numerous cysts.

Polycystic kidney disease can complicate pregnancy. In a significant number of cases, women with this disease can have only one pregnancy, since subsequent pregnancies can lead to the development of complications that can be defined as life-threatening. The highest risk of developing complications is in women who already had high blood pressure before pregnancy.

Polycystic kidney disease leads to the formation of cysts in the liver. The likelihood of this increases with the age of the patient with polycystic kidney disease. It's pretty big. In about 75% of patients diagnosed with polycystic disease, cysts are also found in the liver at one time or another in their lives - they can appear in both women and men. Although, as statistics show, in women, they are often found at an earlier age than in men, and are large (this is due to the activity of female hormones). Women who have previously given birth who are diagnosed with polycystic disease are more susceptible to cysts in the liver.

Polycystic liver disease can lead to many complications. In addition to the above, complications can affect the intestines when a hernia develops in a patient with polycystic kidney disease and sacs appear in the intestinal wall. In addition, chronic pain in the abdomen and back is a common manifestation of polycystic kidney disease. Polycystic disease can lead to the development of heart valve pathology, that is, a situation develops when the mitral valve (the valve that separates the left ventricle of the heart and the left atrium) stops closing in a normal way, with the result that blood is able to leak back.

Polycystic disease is treated therapeutically. Far from it. The fact is that the possibilities of obtaining a favorable result with conservative methods of treatment are very limited. But conservative treatment is also used: its goals are to eliminate infection in the urinary tract, as well as to combat such characteristic signs of polycystic kidney disease as high blood pressure and anemia.
Often the question arises about the need for surgical treatment of polycystic kidney disease. In particular, it is necessary when identifying large cysts, their suppuration, when severe bleeding occurs, as well as with severe pain. Usually, decompression of the polycystic kidney is performed, which means the following: the surgeon punctures the cysts, and then their contents are removed. The name of the operation - ignipuncture - is associated with one of its constituent stages. Nowadays there is a possibility of percutaneous puncture of cysts in the kidney. This means that no open kidney surgery is performed.
With pronounced suppuration of one of the kidneys, an operation to remove it is possible, but the condition for such an operation is the fact that the other kidney is performing its functions (at least partially). There are times when a patient with polycystic kidney disease needs a kidney transplant (one or both).

Polycystic kidney disease can be easily eliminated. Invalid statement. On the contrary, the treatment of this disease is challenging. The fact is that it is almost impossible to stop the development of a process that manifests itself in connection with heredity, therefore, therapeutic treatment is mainly aimed at combating the complications of this disease. If polycystic disease is characterized by the presence of constant pain, then the doctor prescribes analgesic therapy.

Watch the video: ADPKD Mechanism of Disease Video for Health Care Providers (October 2020).