Blood in Urine Caused by PKD

The clinical manifestations of PKD include pains, progressive growth and enlargement of cysts and kidneys, abdominal masses, high blood pressure, blood in urine, protein in urine and renal damages. Why PKD will cause blood in urine and can it be treated?

There are more than 90% PKD patients will have cyst bleeding or gross hematuria (blood in urine). In most cases it is spontaneous and it can also be caused after strenuous activities or physical traumas. The main reasons of blood in urine are rupture of blood vessels on the cysts, kidney stone, infection or cancerization. Generally the hematuria is self-limited and it can disappear within 2-7 days. However, if the bleeding lasts longer than a week or if the patient is above 50, tests need to be done to rule out the possibility of cancerization.

For PKD patients, hematuria is very common symptom in clinic and the color of the urine can be pink, red or brownish red and it can also be microscopic hematuria. Once PKD causes blood urine, patients are susceptible to celiac infection and have high fever; swelling and sharp fall of kidney functions, etc.

Why PKD will cause blood in urine? This is due to the high blood pressure in the patients and high pressure and high perfusion in the kidney. The small blood vessels around the cysts are easy to rupture and cause blood in urine. A few cases will have the complications of kidney stone or urinary tract infections which can also cause hematuria.

It is more difficult to treat hematuria in PKD because it is easy to relapse. Usually bleeding can be stopped within 4-8 days of medicines, but blood in urine will once again occur shortly especially in those that have anemia. The more frequent hematuria is, the higher risk the patients will develop end stage renal disease.

The first thing is to control and prevent infections. Then treatment should aim to eliminate blood stasis and promoting blood circulation. The expansion of the blood vessels can speed up blood flow and increase blood supply to the kidneys so as to alleviate the states of ischemia and hypoxia. This can help provide favorable environment for further repairing and treatments.