Presentation
This leads to progressive impairment of renal function. 7 Patient presentation and history The initial workup of a patient presenting with ADPKD should include a full history and physical exam. [clinicaladvisor.com]
Referral should be considered for patients presenting with cystic renal disease, or those who may be at risk of this. [newcastle-hospitals.org.uk]
Physical signs at presentation in elderly patients with ADPKD. The most common presentation was hypertension in 70.6%. [pubs.sciepub.com]
Homozygotes are thought to die in utero. [ 6 ] Presentation [ 4, 5 ] Most individuals present with complications of the disease. However, increasing numbers are being detected by screening individuals who have an affected relative. [patient.info]
Autosomal Dominant PKD ADPKD usually starts to present with signs and symptoms from the age of 30 years, despite the cysts starting to develop from childhood, or even being present at birth. [news-medical.net]
Entire Body System
- Localized Pain
Splanchnic nerve blockade with local anesthetics or steroids can result in pain relief beyond the duration of the local anesthetic. [revistanefrologia.com]
Workup
ADPKD workup In the initial workup of an individual with ADPKD, special attention should be given to the family history, social history, and medical history as well as to the genitourinary, GI, and cardiac/vascular portions of the physical exam. [clinicaladvisor.com]
Acute Kidney Injury Workup. Medscape Reference. Available online at http://emedicine.medscape.com/article/243492-workup#c13. Accessed May 2016. (April 2014) Seaborg E. New Biomarkers Offer Hope for Identifying Acute Kidney Injury Risk. [labtestsonline.it]
REFERENCES • 1.http://emedicine.medscape.com/article/244 907-workup • 2.Davidson principle and practice 22nd edition • 3.Pathophysiology of polycystic kidney disease,experimental studies by Jeron Nauta [slideshare.net]
Indications for MRA are as follows [6, 7] : Family history of stroke or intracranial aneurysms Development of symptoms suggesting an intracranial aneurysm Job or hobby in which a loss of consciousness may be lethal Past history of intracranial aneurysms See Workup [emedicine.medscape.com]
Urine
- Pyuria
Pyuria is common even without bacterial infection; thus diagnosis of infection should be based on culture results and clinical findings (eg, dysuria, fever, flank pain) as well as urinalysis. [merckmanuals.com]
In the past, the incidence of urinary tract infection may have been overestimated in ADPKD because of the frequent occurrence of sterile pyuria. [revistanefrologia.com]
Treatment
No treatments are currently approved for ADPKD. Early supportive treatment of symptoms to slow disease progression may reduce healthcare utilization and costs by reducing disease burden. [ajpb.com]
Treatment Treatment is symptomatic in the case of ADPKD and also includes monitoring for complications such as heart valve disease and brain aneurysms. In children with ARPKD, treatment is more urgent and intensive. [news-medical.net]
Treatment may include: Pain medication Surgery to shrink cysts and relieve pain Treatment for high blood pressure Treatment for urinary tract infections Dialysis Kidney transplantation Autosomal recessive PKD (inherited) Autosomal recessive PKD is a rare [stanfordchildrens.org]
What is the treatment? Unfortunately there is no cure for this condition. If you are diagnosed with polycystic kidney disease, your treatment will be focused on reducing symptoms, such as high blood pressure and pain. [your.md]
Prognosis
death from renal failure / hypertension / left ventricular failure within 1st year of life INFANTILE FORM · 20% of renal tubules involved + mild / moderate periportal fibrosis · Disease appears by 3-6 months of age · Prognosis: death from chronic renal [learningradiology.com]
Prognosis In ARPKD, the prognosis depends on how early the cysts start to develop. Thus if a developing fetus shows kidney cysts, the disease is more severe than if the cysts first occur after birth. [news-medical.net]
"Polycystic kidney disease: inheritance, pathophysiology, prognosis, and treatment". International Journal of Nephrology and Renovascular Disease. 3 : 69–83. ISSN 1178-7058. PMC 3108786. [en.wikipedia.org]
However, with Logistic regression analysis only anemia was found to be independent risk factor associated with a poor renal prognosis (p = 0.03). [pubs.sciepub.com]
Disease progression and prognosis is quite variable, depending on both genetic and non-genetic factors. [snpedia.com]
Etiology
[ edit ] Two main types Autosomal Dominant PKD (adult PKD) Autosomal Recessive PKD (infantile PKD) ADPKD [ edit ] Etiology and Natural History gene PKD1 mutated in about 85% of cases gene PKD2 mutated in about 15% of cases symptoms usually develop beginning [en.wikibooks.org]
This coincidence makes us inevitably think about a common etiological factor to kidney and infertility anomalies. [elsevier.pt]
Martinez JR, Gramtham JJ: Polycystic kidney disease: Etiology, pathogenesis, and treatment. Dis Mon 1995;16:693–765. Riccardi VM: Neurofibromatosis: Phenotype, Natural History and Pathogenesis, ed 2. Baltimore, Johns Hopkins University Press, 1992. [karger.com]
Grantham JJ: The etiology, pathogenesis, and treatment of autosomal dominant polycystic kidney disease: recent advances. Am J Kidney Dis 28:788–803, 1996. PubMed Google Scholar 14. [link.springer.com]
(Etiology) Polycystic Kidney Disease is an inherited genetic disorder. [dovemed.com]
Epidemiology
PKD1, chromosome 16p, most common) and polycystin 2 (PDK2, chromosome 4q) Also associated with TSC2 / PKD1 contiguous gene syndrome ( Am J Surg Pathol 2002;26:198 ) Usually inherited; new mutations without a family history occur in approximately 10% Epidemiology [pathologyoutlines.com]
Epidemiology of ADPKD: Incidence and Prevalence No primary epidemiology studies for ADPKD, including incidence and prevalence or other important measures (ie, age at onset, disease severity by age, mortality by age) were conducted during the period covered [ajpb.com]
Prevalence and epidemiology ADPKD has an estimated prevalence of one case in every 500 people, affecting approximately 600,000 Americans and as many as four to six million people worldwide. 4 As the most common inherited disorder of the kidneys in humans [clinicaladvisor.com]
The disease database EPIDEMIOLOGY Polycystic kidney disease is the most common life-threatening genetic disease, affecting approximately 7 million people worldwide. [flipper.diff.org]
View Article PubMed Google Scholar Shaw C, Simms RJ, Pitcher D, Sandford R: Epidemiology of patients in England and Wales with autosomal dominant polycystic kidney disease and end-stage renal failure. [bmcnephrol.biomedcentral.com]
Pathophysiology
Pathophysiology A decrease in urine-concentrating ability is an early manifestation of ADPKD. The cause is not known. [slideshare.net]
"Polycystic kidney disease: inheritance, pathophysiology, prognosis, and treatment". International Journal of Nephrology and Renovascular Disease. 3 : 69–83. ISSN 1178-7058. PMC 3108786. [en.wikipedia.org]
[…] polycystin 2 (PDK2, chromosome 4q) Also associated with TSC2 / PKD1 contiguous gene syndrome ( Am J Surg Pathol 2002;26:198 ) Usually inherited; new mutations without a family history occur in approximately 10% Epidemiology 1 - 2 / 1000 births Males = female Pathophysiology [pathologyoutlines.com]
This article gives an overview of hypertension, cardiac complications, and intracranial aneurysms in ADPKD, their pathophysiology, and recent developments in their management. [mdedge.com]
Pathophysiology of childhood polycystic kidney diseases: new insights into disease-specific therapy. Pediatr Res. 2014 Jan;75(1-2):148-57. doi: 10.1038/pr.2013.191. Epub 2013 Oct 31. Review. Sweeney WE, Avner ED. [ghr.nlm.nih.gov]
Prevention
Reassure that this could not have been prevented Recommended Follow-up for PKD [ edit ] renal ultrasounds to monitor cysts and function control of hypertension CT scan to detect aneurysm (ADPKD) monitor liver function Resources [ edit ] PKD foundation [en.wikibooks.org]
Prevention - Polycystic Kidney Disease - Type 1 Not supplied. Diagnosis - Polycystic Kidney Disease - Type 1 The main method used to diagnose APKD is an ultrasound. [checkorphan.org]
However, some people with ARPKD do not develop signs or symptoms until later in childhood or even adulthood Can I prevent PKD? Researchers have not yet found a way to prevent PKD. [my.clevelandclinic.org]
This involves controlling high blood pressure, restricting protein in the diet, controlling build up of acid (acidosis) and preventing elevated levels of phosphate (hyperphosphatemia). [genome.gov]
Continued Treatment There is no cure for ADPKD, but you can treat the health problems that the disease causes and possibly prevent kidney failure. You may need: Medicine to prevent kidney failure. [webmd.com]