Polycystic Kidney Disease:Treatment and Causes

Polycystic kidney disease is an autosomal genetic renal disorder. According to different hereditary mode, it can be divided into two categories---ADPKD and ARPKD. The former is dominant and the latter is recessive.

A new theory on the cause of PKD was put forward in 1996 and it holds that only abnormal gene can not cause the onset of PKD and patients can develop the disease only under some acquired factors such as infections, toxins, etc. That is to say, there are two times of gene mutations---reproductive mutation (from heredity) and somatic mutation (from acquired factors after birth).

Since PKD is caused by gene mutation, there is at present no cure for it and patients have to suffer from it for lifelong time and will pass the pathogenic gene to the following generations.

Though there is no complete cure for PKD, there are still a lot can be done and improve to control complications and slow down illness progression. The principles for treating PKD are lower its birth rate of diseased babies, early detection and regular checks, control and treatments for complications and for end stage PKD patients, renal replacement therapies---dialysis and kidney transplant to sustain life expectancy.

Treatments for PKD symptoms and complications:

1. Pains. Observation for transient pain; if the pain is persistent or severe, analgesic can be used, but the effects are usually unsatisfying; if the pain is unbearable and affect the patients’ normal life, surgical removal of large cysts can be considered, but more precaution should be made before the surgery.

2. Bleeding. Bleeding can be caused by cyst rupture, kidney stone or hypertension, therefore the first step is to find out the underlying cause and remove it and have adequate bed rest. Blood transfusion is necessary if there is large amount of bleeding and in refractory conditions; selective renal artery embolization or nephrectomy can be done.

3. Hypertension. It is one common complication and also one major deterioration factor of kidney functions. Strict control of blood pressure can slow down decline rate of kidney function and lower its death rate. Medicines such as ACEI, ARB and calcium channel blockers can be used treat high blood pressure. The ideal blood pressure level is 130/80mmHg. If high blood pressure can not be controlled, surgeries can be considered.

4. Infections. Infections in urinary system and cysts are very common in PKD patients. The combined use of water soluble and fat soluble antibiotics can have good effects.

Some Chinese herbal medicines can be combined with western medicines and surgeries to strengthen curative effects.