PKD(Polycystic Kidney Disease) is a kind of hereditary disease. It is a genetic cystic disorder of the kidneys. PKD is characterized by numerous cysts with varying sizes. These fluid-filled sacs will enlarge and increase along with age and oppress surrounding tissues and finally damage renal structure and functions and lead to renal failure. This disease can also affect the liver, pancreas and in some rare cases, the heart and brain. There are two types of PKD: autosomal dominant polycystic kidney disease(ADPKD) and autosomal recessive polycystic kidney disease(ARPKD) according to different hereditary modes. ARPKD is much more rare in clinic.Back top
1.Congenital dysontogenesis or genic mutation
2.Infections: Infections can change the internal environment and this will create a favorable environment for cystic gene to mutate. In that case, the activity of inner factor of cysts will be increased, so the growth of cysts will be speed up. The common infections include: upper respiratory tract infection, urinary tract infection, gastrointestinal tract infection, skin infection, trauma infection and equipment infection and so on.
3.Toxins: Toxins can damage all kinds of cells, tissues and organs. Also it is one of the main reasons causing congenital dysontogenesis and genic mutation.
4.Diet: Unreasonable eating habit may cause many diseases.
5.Psychological pressure or bad mood: Bad mood can lower people's immunity, so the body is susceptible to be attacked by germs or virus.Back top
1.Prevent catching cold. PKD is a hereditary disease which will accompany the patients for lifelong time. Cold and infections will speed up the illness progression.
2.Prevent physical traumas. The multiple cysts in the kidneys will experience progressive enlargement and increase the capsule internal pressure. In such case, any light trauma like bump, sprain will further increase the pressure and have impact on large cysts which will cause the cysts to rupture and bleed.
3.Well control of hypertension. High blood pressure will speed up renal damages and cause cerebrovascular damages, therefore it is crucial to bring the blood pressure well under control for slowing down the deterioration of renal function.Back top
We all know that an accurate diagnosis is the crucial premise for effective treatments. Then what are the tests that patients should take in order to diagnose PKD.
1. Routine urine test. There will be proteinuria and gross hematuria or microscopic hematuria, pyuria and bacteriuria are also very common.
2. Urine osmotic pressure. In the early stage the renal concentration function will be affected.
3. Serum creatinine. The serum creatinine level will increase gradually with the progressive loss of kidney functions. Creatinine clearance rate is more sensitive indicator than creatinine.
4. KUB shows enlargement of the kidneys and the shape is irregular.
5. IVP (Intravenous pyelogram) shows sign of compressive deformation.
6. B ultrasound shows many dark areas in bilateral kidneys.
7. CT (computerized tomography) scan shows enlargement of bilateral kidneys and the renal shape is lobulated with many fluid-filled sacs.
8. MRI (magnetic resonance imaging) is very effective in detecting aneurysm which is a major cause of early death for PKD patients.Back top
Hypertension is a common symptom of PKD. 80% of patients with ESRD (end-stage renal disease) have high blood pressure. Blood pressure has a direct relation with the size of kidneys and the number of cysts. With the age growing, blood pressure will worsen. Also high blood pressure can in turn aggravate PKD.
When PKD patient's kidney enlarge to a certain degree, the surface of kidney texture will be nodosa, it will move while breathing.
3.Hematuria (blood in urine)
With the enlargement of cysts, these cysts will oppress the kidney tissues and blood vessels in kidneys, which will cause microcirculation disturbance The kidneys will be in a state of hypoxic-ischemic, which will lead to the damage of capillary endothelial cell of kidneys. So blood in urine will appear. As for those PKD patients with high blood pressure, the small blood vessels around cysts are especially easy to rupture.
If PKD develops into ESRD, then about 80% of patients will have proteinuria and it is more common among male patients than the female.
5. Back pain and flank pain. Back pain or flank pain is the most common symptom of ADPKD. Chronic pain is due to stretching of the renal capsule and oppression to surrounding renal tissues and organs. Sudden pain or sharpened pain often indicates cyst rupture, kidney stone or urinary tract obstruction and infections caused by blood clots.
Besides , PKD patients will also have the following symptoms including bleeding, renal impairment, frequent urinary tract infections as well as many extra-renal symptoms such as polycystic liver, diverticulosis, aneurysm, etc.Back top
Since PKD is a congenital and hereditary disease and it is related to gene mutation, there is at present no instant cure for it. What can be done is to deal with the symptoms and complications and slow down the development of the illness condition. These symptoms and discomforts can be alleviated in a short time, however the renal damage can not be reversed and the kidney function will be gradually lost and in the end patients will have no choice but dialysis and kidney transplant.
Operations such as aspiration and decortication can help remove the cysts in a short time, however they are more suitable for single and large cysts and the recurrent rate is high and they can not reverse the continuous deterioration of renal functions. They are especially not suitable for PKD patients because their kidneys are full of varying sizes cysts. PKD will progress gradually into end stage renal failure and at that time patients will have no choice but dialysis and kidney transplant.
2. Traditional Chinese Medicines(TCM)
As we know the continuous deterioration of renal function is caused by the progressive enlargement and increase of the cysts, therefore the key point is to slow down their growth rate and try to shrink them to smaller size. In this regard, Tradition Chinese Medicines have particularly good effects on shrinking these multiple cysts and at the same time regulating disorders and repairing kidney damages. Though it take relatively longer time to take effect compared with western therapies, its curative effects can last for a long time since it deal with the disease from the root. And what is more it has far fewer side effects and injuries to the body. Even though, many patients are reluctant to take TCM due to its bitterness, inconvenience and slow effects.
Micro-Chinese Medicine Osmotherapy
Micro-Chinese Medicine Osmotherapy is a creation and innovation based on TCM. It can slow down the growth rate of the cysts and shrink the cysts.
Its mechanism in shrinking cysts;
1. Expand blood vessels around the cysts, speed up blood circulation and increase the permeability of the cyst wall. This will lower the intravascular pressure and cause cystic fluids to be re-absorbed to the blood vessels and be taken away with blood circulation.
2. The active ingredients in Micro-Chinese Medicines can deactivate the epithelial cells and inhibit the continuous secretion of cystic fluid so as to prevent further swelling of the cysts and blood vessels in the cyst wall. At the same time these medicines can provide necessary nutrition for repairing renal damaged cells and tissues.
Its curative effects:
① Reduce the secretion of cystic fluids and alleviate oppression to glomeruli, renal tubules and blood vessels, speed up blood circulation and improve hypoxia and ischemia.
② Active ingredients in the medicines can block the deterioration chain of renal fibrosis and protect the remaining functional renal intrinsic cells from further damages.
③ Micro-Chinese Medicines can provide materials for repairing damaged renal cells such as various vitamins, trace elements, organic acid, amino acid. The DNA in the damaged cells will also be activated and this can speed up the repairing and recovery of kidney functions.
As to the causes of PKD, there is a new theory called two-hit which holds that only heredity of mutated polycystic gene (reproductive mutation) can not cause PKD. Only when the allele gene has mutation (somatic mutation) can PKD occur. That is why some patients can go through their entire life without PKD affecting their daily life even they have inherited the polycystic gene while some patients have symptoms and discomforts quite early.
The somatic mutation is induced by acquired factors after birth such as infections, poisoning, etc. Therefore PKD can be prevented if we can prevent the second hit, that is the somatic mutation. The key point is to build up physical strength, enhance immunity and at the same time stay away from risk factors.
Immunotherapy combines the advantages of Chinese therapy and western therapy and it can treat both the primary and secondary aspects of PKD at the same time. It can not only alleviate the symptoms but also regulate the disorders of the immune system and improve immunity so that patients can be strong enough to resist virous viruses and bacteria. This can help lower the incidence of second hit and recurrent rate.Back top
PKD patients should take foods in a balance amount, not too much or too little. As for PKD patients, they can have less food at one time but more times in one day to keep energetic and nutritious.
1. PKD patients should have more water (4000ml) and the urine output should be maintained at about 2000-2500ml.
2. Polluted foods which can cause gastrointestinal diseases or even poisoning symptoms should be forbidden.
3. PKD patients should have a diet with low salt, low fat and low protein. They should avoid beef and mutton, animal innards as well as spicy and excitant foods. Uncooked and cold foods which may injure spleen and stomach should be limited in a certain amount which should depend on patients' specific illness and physical conditions.
4. More fruit and vegetables with rich vitamins are suggested especially those that have the functions of dissolving stones and diuresis. Alkaline foods should also be eaten more.
5. PKD patients should avoid alcohol, tobacco, strong tea and foods and drinks containing caffeine.Back top
Infantile PKD usually die of renal failure within several month after birth while the progression of adult PKD is very slow and the average life expectancy is about 50 years and the average survival time is about 10 years after symptoms appear. However the prognosis vary a lot from individual to individual and some cases can even go through their whole life without PKD affecting their normal life.Back top
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