Polycystic Kidney Disease
What is polycystic kidney disease?
Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts filled with fluid in the kidneys. PKD cysts can reduce kidney function, leading to kidney failure. People with PKD can also have cysts in the liver and problems in other organs such as the heart and blood vessels in the brain.
There are two primary inherited forms of PKD and one non-inherited form:
Autosomal dominant PKD is the most common inherited form of polycystic kidney disease, accounting for about 90 percent of all PKD cases. Autosomal dominant means that if one parent has the disease, there is a 50 percent chance that the disease will pass to a child, and that both males and females are equally affected. These cases are usually diagnosed in adulthood.
Autosomal recessive PKD is a rare, inherited form of polycystic kidney disease thought to be caused by a particular genetic flaw that is different from the genetic flaw that causes autosomal dominant PKD. Parents who do not have the disease can have a child with the disease if both parents carry the abnormal gene and both pass the gene to their child. Carrier parents have a 25 percent chance with each pregnancy to have a child with this type of PKD. Males and females are equally affected. Autosomal recessive PKD is sometimes detected before birth using a fetal ultrasound.
Acquired cystic kidney disease (ACKD) may develop in association with long-term kidney problems, especially in people who have kidney failure and who have been on dialysis for a long time. Therefore, it tends to occur later in life and is an acquired, not inherited, form of PKD. Often there are cysts in other organs such as the liver and the pancreas.
What are the symptoms?
Symptoms may vary by type of PKD, but common symptoms include:
- High blood pressure
- Urinary tract infections
- Frequent urination
- Abdominal pain
What treatment options are available?
Treatment for polycystic kidney disease may include pain medication, surgery to shrink cysts and relieve pain, treatment for high blood pressure, treatment for urinary tract infections and in some cases, dialysis and kidney transplantation.
- Peritoneal dialysis. Peritoneal dialysis is performed by surgically placing a special, soft, hollow tube into the lower abdomen near the navel. After the tube is placed, a special solution called dialysate is instilled into the peritoneal cavity, the space in the abdomen that houses the organs. The dialysate is left in the abdomen for a designated period of time as determined by your physician. The dialysate fluid absorbs the waste products and toxins through the peritoneum. The fluid is then drained from the abdomen, measured, and discarded. There are two different types of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD) and continuous cyclic peritoneal dialysis (CCPD):
- CAPD does not require a machine. Exchanges, often referred to as passes, can be done three to five times a day, during waking hours.
- CCPD requires the use of a special dialysis machine that can be used in the home. This type of dialysis is done automatically, even while you’re asleep.
- Hemodialysis. Hemodialysis is performed in a dialysis center by trained health care professionals. A special type of access, called an arteriovenous (AV) fistula, is placed surgically, usually in the arm. This involves joining an artery and a vein together. After access has been established, you will be connected to a hemodialysis machine that drains your blood, bathes it in a special dialysate solution that removes waste substances and fluid, then returns it to your bloodstream. Hemodialysis is usually performed several times a week and lasts four to five hours per visit.