Complications of polycystic kidney

What are the complications of polycystic kidney? Does polycystic kidney disease affect anything? These are frequently asked questions in patients with kidney disease. The most common complication of polycystic kidney disease is that it can lead to kidney failure, kidney cancer, but so far there is no specific treatment. Read on to learn more about polycystic kidney disease.

Polycystic kidney disease is an inherited disease involving bilateral kidney cysts. The condition is divided into two types: autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD) or recessive polycystic kidney disease. Autosomal dominant polycystic kidney disease is one of the most common genetic disorders in humans and the most common genetic cause of kidney failure in adults, accounting for 6-8% of dialysis patients. blood in the United States. It is a multisystem and progressive disorder characterized by cyst formation and enlargement in the kidneys and other organs (eg, liver, pancreas, spleen). Clinical manifestations usually begin in the third to fourth decade of life, but cysts can be detected in infancy and in utero. Up to 50% of patients with autosomal dominant polycystic kidney disease typically require renal replacement therapy by age 60.
Autosomal recessive polycystic kidney disease is often characterized by cystic dilation of the collecting tubules associated with varying degrees of liver abnormalities, including biliary dysplasia and cyclic fibrosis. Because. This disorder is usually diagnosed in infants and children, although liver abnormalities may not manifest in neonates (50-60%).
Just as polycystic kidney disease can invade the liver, dominant polycystic liver disease (ADPLD) can involve cysts in the kidney, although if present they are very rare. . However, like patients with ADPKD, patients with systemic polycystic liver disease also present with abdominal pain as the liver cysts enlarge and cause hepatomegaly.

Worldwide, polycystic kidney disease affects approximately 4-7 million people and accounts for 7-15% of patients on renal replacement therapy. It is also one of the most common serious genetic diseases, found in a ratio of 1:400 to 1:1000 individuals, and is by far the most common genetic cause of end-stage renal failure. ESRF). It accounts for 4-10% of all ESRF cases.
So does polycystic kidney disease affect anything? Renal cysts in ADPKD are associated with excessive angiogenesis as fragile vessels extend past their distended walls. With trauma, these blood vessels can leak blood into the cyst, causing it to expand rapidly, resulting in intense pain. If bleeding continues, the cyst can rupture into the collection system, causing gross hematuria. Alternatively, the cyst may rupture into the subcapsular space and eventually dissect through the renal capsule to fill the retroperitoneal space.
ADPKD causes progressive renal dysfunction, leading to enlarged kidneys and kidney failure by the age of 40 to 60 years of life. Although the two forms of ADPKD, ADPKD1 and ADPKD2, share similar clinical features, the renal prognosis is markedly different. ADPKD2 is a milder disease, based on the age of ESRD onset. The median age of kidney survival for people with ADPKD1 is 56 years, compared with 68 years for those with ADPKD2. However, although ADPKD2 was milder than ADPKD1, it had an overall impact on survival and shortened life span. Cardiovascular diseases and infections account for about 90% of deaths in patients treated with hemodialysis or peritoneal dialysis and after kidney transplantation. A rare cause of death in ADPKD is subarachnoid hemorrhage due to an intracranial aneurysm.
The very numbers of the day have also shown you how dangerous it is as well as its significant impact on our health.

End-stage renal disease (ESRD) is the most common complication of ADPKD.
Complications or problems of ADPKD can affect many systems in your body besides the kidneys.
You may see some ADPKD complications right away. Other complications may not appear for many years, depending on whether you have the PKD1 or PKD2 gene. Also, ADPKD complications can vary from person to person, so you may not have all of these problems.
3.1. Vascular system problems Abnormal heart valves can occur in some people with ADPKD. Abnormal heart valves can cause too little blood to flow into the aorta, the large artery that carries blood from your heart to the rest of your body. Abnormal heart valves in people with ADPKD rarely need to be replaced. However, you may need more tests if your doctor finds a heart murmur linked outside of a national health research agency.
3.2. Brain Aneurysm Brain aneurysm is one of the most serious complications of ADPKD; They occur in 4-10% of patients with ADPKD, and mortality from cerebrovascular events is about 7% in patients with ADPKD. An aneurysm is a bulge in the wall of a blood vessel. An aneurysm in the brain can cause a headache that is severe or feels different from other headaches. See your doctor even before you take an over-the-counter pain reliever for severe headaches or headaches that don't go away.
Brain aneurysms can burst and cause bleeding inside the skull. Rupture usually occurs in patients under 50 years of age with uncontrolled hypertension; however, hypertensive stroke and hemorrhagic stroke are more common. There is no relationship between the risk of rupture and the severity of kidney disease.
A large brain aneurysm is life-threatening and requires immediate medical treatment. If you have an aneurysm, stop smoking and control your blood pressure and lipids
3.3. Digestive system problems The presence of cysts in the liver, pancreas and spleen is a prominent feature of polycystic kidney disease, which is a frequent manifestation of ADPKD. Pain and infection are the only symptoms that occur with liver cysts. Usually, cysts have no symptoms.
Polycystic liver disease belongs to a group of liver diseases characterized by overgrowth of the biliary epithelium and supporting connective tissue, which is also the most common nonkidney complication of ADPKD. It is characterized by multiple cysts that may be small in size or may occupy most of the abdominal cavity. Liver size can range from normal to enlarged.
Liver cysts usually do not cause symptoms in people under 30 years of age, because liver cysts are often small and few in number in the early stages of ADPKD. In rare cases, liver cysts can eventually reduce liver function. In the most severe cases, you may need a liver transplant.
Because the hormone estrogen can affect the growth of liver cysts, women are more likely to have liver cysts and often larger tumors than men. Liver size in large polycystic liver disease tends to stabilize after menopause. Liver cysts occur in nearly 50% of affected patients. Cysts occur in about 20% of patients in the third decade of life and 75% in the seventh decade of life. They are rare in children and their frequency increases with age. Pancreatic cysts occur in 9% of patients over 20 years of age.
Bilateral nephrectomy in patients with massively enlarged liver can cause portal hypertension. This often manifests as severe ascites or esophageal varices. An enlarged liver can also cause malnutrition and, in such cases, the patient may require a partial liver resection or a liver transplant.
3.4. Pancreatic cysts The PKD gene can also cause cysts in your pancreas. Pancreatic cysts rarely cause pancreatitis, which is inflammation or swelling of the pancreas.
3.5. Diverticula Diverticula are small sacs, or pouches, that push through weak spots in the wall of your colon. Diverticula can cause diverticular disease. Diverticulosis can cause changes in your movement patterns or pain in your abdomen.
3.6. Urinary tract problems Urinary tract infections (UTIs). Kidney cysts can block the flow of urine through the kidneys, causing urine to stay too long in your urinary tract. When urine stays in the urinary tract for too long, bacteria in the urine can cause a bladder infection or kidney infection. A kidney infection can cause further damage to your kidneys by causing the cysts to become infected.
3.7. Kidney stones People with ADPKD sometimes get kidney stones. Kidney stones can interfere with the flow of urine, causing infection and pain.
Kidney stones occur in 20-30% of patients with ADPKD. This should be considered in patients with acute pain and hematuria. In contrast to kidney stones in the general population, which often consist of calcium oxalate, uric acid stones form in approximately 50% of patients with ADPKD. Metabolic abnormalities (eg, decreased urinary citrate) contribute to uric acid stone formation.
Confirmation of the diagnosis by ultrasound is often difficult because of the presence of large cysts. Automated venous computed tomography or CT is the preferred imaging modality.
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