Polycystic kidney disease in adults

What is polycystic

The term polycystic kidney disease or polycystic disease is a serious malformation of organs in which the correct formation of the renal tubules that collect urine and direct it to the pelvis is disrupted. In the area of ​​the tubules, small cysts appear – vesicles filled with fluid. Kidney damage in polycystosis always occurs on both sides, the size of the cysts can be from a match head to a large cherry and even more. Inside they contain a jelly-like mass of light or brown color.

The growth of cysts with age leads to the fact that the number of functioning cells (nephrons) is reduced, and this leads to the development of kidney failure. Often, with polycystic kidney disease, the spleen, pancreas, seminal vesicles, liver, lungs, or other organs also suffer.

Causes of polycystic kidney disease in adults

“Polycystic disease is a genetic disease caused by the degeneration of the kidney parenchyma with the formation of multiple cysts of various sizes,” says urologist-andrologist Alexander Danilov. – This occurs as a result of a violation of the formation of functional units of the kidneys – nephrons – in the prenatal period. Part of the nephrons in polycystic disease do not connect with the collecting system of the kidney. This causes liquid to accumulate in them. They turn into cavities with fluid – cysts. There are from 20 to 50 such cysts. Outwardly, the affected kidney resembles a bunch of grapes. Cysts can be of different sizes and shapes, while the affected organ can reach a mass of up to 2 kilograms.

Important! In adults with polycystic disease, the kidney retains a sufficient amount of fully functioning renal tissue, so clinical manifestations of the disease may occur late or be completely absent.

Symptoms of polycystic kidney disease in adults

In many ways, the symptoms depend on the age at which the first signs of pathology appear. If they occur in the newborn period, the pathology has an unfavorable course and quickly leads to death due to the development of uremia (poisoning by metabolic products that the kidneys must remove).

If it is adult polycystic, it typically has a slow, progressive development. The disease proceeds in several stages – compensated, subcompensated and then transition to decompensation.

In the stage of compensation, initially there are no symptoms. Over time, you may experience:

• feeling of pressure in the lumbar region;
• pain in the abdomen of various nature;
• urination disorders due to stretching of the kidney tissue;
• fatigue;
• headache;
• blood in the urine.

The main functions of the kidneys at this stage are not violated.

At the stage of subcompensation, the first signs of kidney failure appear:

• nausea and dry mouth, thirst;
• headaches or migraines;
• very persistent increase in blood pressure;
• polyuria (copious urine output) with low density;
• blood in the urine, cylinders, leukocytes (if pyelonephritis joins);
• fever, toxicosis, chills if the cysts suppurate;
• attacks of renal colic, if urolithiasis joins.

In the stage of decompensation, a constant uremia (urinary circulation) is formed. Without hemodialysis, the patient feels extremely unwell, serious complications arise.

Treatment of polycystic kidney disease in adults

The tactics of treating polycystic disease largely depend on the stage of the disease, the accompanying symptoms and the age of the patient. In the initial stages, maximum preservation of kidney function, protection from infections is necessary.

Diagnostics

In order to make a diagnosis, you need to carefully study the history of the family – most often familial cases of polycystic disease are detected. The doctor also conducts a complete examination, probes the abdomen – sometimes he can identify enlarged, bumpy kidneys. But it is possible to confirm the diagnosis only after carrying out tests and additional examinations:

• Ultrasound of the kidneys;
• nephroscintigraphy (using radioisotope substances);
• excretory urography (with the introduction of a contrast agent and x-ray of the kidneys);
• CT or MRI of the kidneys;
• selective angiography (to determine how the kidney feeds on blood);
• intravenous urography – it helps to determine a significant increase in the kidneys on both sides, the type of deformation of the cups and pelvis.

Additionally, urine samples according to Reberg, Zimnitsky, biochemistry of blood, urine, urine culture for sterility to exclude infection can be prescribed. Genetic testing is also carried out.

Modern treatments

Since PCOS is a genetic disease, there is no specific treatment. That is, it is not possible to prevent its development, – says Dr. Alexander Danilov. – The main treatment is symptomatic. It is divided into conservative and surgical.

Conservative treatment. Its goal is to reduce the manifestations of the disease and prevent complications. For example, with an increase in blood pressure, antihypertensive therapy is carried out. With the development of inflammation of the kidneys (pyelonephritis), antibacterial drugs are used. With protein deficiency – preparations of amino acids. If anemia develops (a decrease in the concentration of hemoglobin in the blood), iron preparations, erythropoietin are used.

With a decrease in the amount of urine excreted (reduced diuresis), diuretics may be prescribed. In severe renal impairment, hemodialysis or peritoneal dialysis is performed.

Surgery. With a rapid increase in cysts in volume, a puncture or laparoscopic excision is performed. Surgical reduction of the volume of cysts leads to a decrease in compression of the remaining kidney tissue and an improvement in blood circulation in it. This allows the remaining normal kidney tissue to work. In severe kidney failure, a kidney transplant is performed.

Prevention of polycystic kidney disease in adults at home

Unfortunately, there is no specific prevention of the disease. This is a genetic disease, it is extremely difficult to predict its development. If there are patients with polystosis in the family, consultation with a geneticist is necessary.

Popular questions and answers

How can polycystic disease be complicated and can it be radically cured, can traditional medicine or dietary supplements be used, we asked urologist-andrologist Alexander Danilov.