POLYCYSTIC KIDNEY DISEASE

• Adult polycystic kidney disease (APKD) is an autosomal dominant disorder. The cortex and medulla of both kidneys are usually filled with thin-walled, spherical cysts that enlarge and compress intervening renal tissue, thereby interfering with renal function.

• APKD may be associated with hepatic cysts in more than 75% cases (adult hepatorenal polycystic disease).

• Clinical presentation may be at any age from the second decade. Presenting manifestations include hypertension, acute loin pain and haematuria resulting from haemorrhage into a cyst or renal calculus, vague abdominal discomfort due to increased size of the kidneys, and symptoms of uraemia and UTI (pyelonephritis and renal cyst infection).

• Polycythaemia (due to increased erythropoietin production), mitral valve prolapse and abdominal hernias are common accompaniments.

• Berry aneurysms of the cerebral vessels are common (10-30%) associations, and may result in subarachnoid haemorrhage.

• Physical examination commonly reveals large irregular kidneys.

• Abdominal ultrasound is the investigation of choice. IVU (rarely done) may demonstrate the characteristic "drooping water-lilly sign". MRI is more sensitive than ultrasound to detect small cysts.

• Treatment includes control of hypertension, control of pain, treatment of infection, and renal replacement by dialysis or transplantation, if required.

• Screening of family members helps to detect this condition.

 

 

TREATMENT AT DR. SOHAN LAL CLINIC

The integrated POLYCLINIC facility offers patients to select their treatment either from the Department of Homeopathy or from the Department of Medicine.

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