INTRODUCTION
There are many different conditions, diseases, infections and disorders that can negatively affect human beings, damaging their bodies, compromise overall health, diminish their quality of life and very often lead to the sufferer’s death. Polycystic kidney disease in one of these more serious conditions. Polycystic kidney disease is an incurable condition that encourages the growing of cysts which can overtake the kidneys, cause them to malfunctions and even fail all together. More than 600,000 people in the United States are living with polycystic kidney disease and the condition contributes to more than 5% of all cases of kidney failure identified (National Kidney Foundation, 2016). In order to understand the condition better it is best to look at its history, causes, symptoms, diagnosis, prognosis and, finally, the treatments relied upon to benefit patients.
DISCUSSION
Information regarding people suffering from polycystic kidney disease can be traced back to the 16th century, but was more heavily researched in the 1800s (National Kidney Foundation, 2016). On the right one can see how this disease ravages and overtakes the kidneys, on the left is a healthy average kidney and enlarged on the right is a kidney with PKD. One can see just how severe the condition can be. Polycystic kidney disease again leads to fluid-filled cysts to grow and, in some ways consume, the kidneys. The type of polycystic kidney disease appears to determine which kind of PDK they may inherit or develop. There are three distinct types of polycystic kidney disease.
Autosomal Dominant PKD: The most common type diagnosed is ADPKD; more than 90% of cases are ADPKD. It is passed from parent to child genetically through dominant inheritance; it usually does not show symptoms until the sufferer reaches the ages 30 to 40 (Web MD, 2016).
Infantile (Autosomal) Recessive PKG: Passes from child to parent through recessive inheritance. These individuals can show symptoms in earliest life, even while still in the womb (National Kidney Foundation, 2016).
Acquired Cystic Kidney Disease: This is developed over years of long-term kidney damage and excess scarring from previous damage. Many people undergoing kidney dialysis will develop this rarer version of PKD (National Kidney Foundation, 2016).
PKD is a condition that runs in families so the likelihood of developing the condition is higher than those who do not. If someone in the family, especially a parent has PKD, then their offspring will likely have the disease as well. The genetic causes of PKD involve mutations to PKD1 and PKD2, genes, the former is more likely to produce ultimate kidney failure. However what is clear is that there is correlation with mutations of PKHD1; they interfere with the cellular signals to grow, leading to enlargement (Igarashi & Somlo, 2007).
Symptoms: There a number of symptoms associated with the possibility of polycystic kidney disease, including severe pain in the side or back, blood present in their urine, high frequency of bladder or kidney infections, enlargement of the abdomen and high blood pressure. In some cases there is the sensation of “fluttering” or pounding heart beat, due to a “floppiness” developed in heart valves (Torra, 2016).
Diagnosis: Hypertension is one of telltale signs of ADPKD, as well as other conditions. In PKD there is a rise in the diastolic number rises (Torra, 2016). If someone is showing a number of these symptoms and polycystic kidney disease is likely the easiest and least invasive means of making a determination is through ultrasound. If the PKD is present then it would show the enlarged cysts. As seen on the right, the sonographic imagery can highlight the amount, severity and provide definitive diagnosis of the presence of polycystic kidney disease. Because so many of the symptoms and signs can also be indicative of many other independent conditions and diseases. However, once a sonographic image is provided, then it can confirm the suspicion of PKD. They may also do a “computed tomography scan,” or CT scan or “magnetic resonance imaging,” or MRI, because they can detect the presence of smaller cysts that exist at the earliest stages of growth (National Kidney Foundation, 2016).
Treatment: Once again, there is no cure currently for PKD, but there is also no specific means of preventing the conditions, especially given its genetic origins in most cases. However, it is possible to treat the symptoms, slow the growth of cysts and slow the deterioration of kidney function. Some of the day-to-day treatments include advising patients to engage in drinking lots of water, especially if blood is in urine, avoid caffeinated beverages as it may increase cyst growth, and engage in low salt diet, maintain weight, engage in exercise and avoid smoking of any kind (Torra, 2016). Medical treatments that the physician may suggest is more prompt antibiotic treatments when a bladder or kidney infection are detected, provide safe pain medications and prioritize monitoring of patients blood pressure. Many other organs, like the pancreas, spleen, ovaries the large bowel and the liver can all be negatively affected by PKD and can lead to other disorders like, metabolic acidosis, hyperkalemia, hypocalcemia, hyperphosphatemia, and hyperparathyroidism, which must also be medically addressed (National Kidney Foundation, 2016). In the meantime research continues to be conducted in order to find greater treatments and potentially preventions in the future. One study focused in the development of TEMPO 3/4, which is a treatment that has shown that it is possible to literally slow the progression of the cystic diseases and renal function in human beings. This treatment has not yet been approved for use, but its research is considered highly promising (Chang, & Ong, 2013).
Prognosis: For many patients the prognosis is good. If the patient follows the physician’s advice, monitors and addresses the symptoms, impedes growth of cysts and makes the dietary changes necessary, then their outlook is promising. PKD is a slow moving disease and not all patients that suffer from PKD will reach kidney failure, however, for those that do, a transplant may be necessary; if they are free of other diseases than they are generally good candidates for transplant. Again, more and more research is being done to address the symptoms, approach the condition at its earliest stages and ultimately find the means to change or eliminate the hereditary nature of the conditions by altering the mutations that are causing the condition (National Kidney Foundation, 2016).
CONCLUSION
Polycystic kidney disease is a very serious condition and is currently one of the most common conditions regarding the kidneys that human beings can develop and it can lead to more serious side effects, including kidney failure and, without interventions, death. The condition is unavoidable for many due to its hereditary nature, but addressing effectively is incredibly beneficial. Many people can live fairly normal lives as long as they are willing to make lifestyle changes that are more conducive to healthy kidneys and follow the doctor’s advice and take the prescribed medication. Suffering through kidney failure, dialysis procedures and the need of a kidney transplant are experiences that no one wants to face in their lifetime, but they are all a possibility with the development of polycystic kidney disease. Fortunately, with current treatments and future endeavors there is the likelihood of more aggressive treatments and possible cures. Continuing research into PKD is definitely paramount and worthwhile.
REFERENCE
Chang, M. and Ong, A.C.M. (2013). New treatments for autosomal dominant polycystic kidney
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Igarashi, P. and Somlo, S. (2007).Polycystic Kidney Disease. Journal of the American Society
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Torra, R. (2016). Polycystic Kidney Disease Clinical Presentation. Medscape. 1-3. Retrieve June
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