DIGESTIVE DISORDERS CENTERTOPIC GUIDE

How Does Polycystic Kidney Disease Affect the Kidneys?

Medical Editor: John P. Cunha, DO, FACOEP

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What Is Polycystic Kidney Disease?

What Are the Symptoms of Polycystic Kidney Disease?

What Causes Polycystic Kidney Disease?

How Is Polycystic Kidney Disease Diagnosed?

What Is the Treatment for Polycystic Kidney Disease?

What are the Risks and Complications of Polycystic Kidney Disease?

What Is the Life Expectancy for Polycystic Kidney Disease?

Can You Prevent Polycystic Kidney Disease?

How Does Polycystic Kidney Disease Affect the Kidneys? Topic Guide

What Is Polycystic Kidney Disease?

This illustration shows a kidney afflicted by polycystic Kidney Disease (PCKD) compared with a healthy
kidney.

This illustration shows a kidney afflicted by polycystic Kidney Disease (PCKD) compared with a healthy
kidney.

Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder that causes cysts
to form in the kidneys and kidney enlargement. Polycystic kidney disease is a progressive illness and it
can affect other organs in the body, such as the liver, pancreas, and spleen. About half of all ADPKD
patients will require a dialysis or kidney transplant by the age of 60. ADPKD occurs in about 1 out of
1,000 people.

Patients with polycystic kidney disease are also at higher risk for intracranial aneurysms.
What Are the Symptoms of Polycystic Kidney Disease?

The most common symptom of polycystic kidney disease is pain in the abdomen. Pain may also radiate
to the sides (flank), pelvis, back, or chest.

Other symptoms of polycystic kidney disease may include:

Ache and discomfort in the abdomen or sides

Sensation of heaviness or fullness in the abdomen

Urinary tract infections (UTIs)

Blood in the urine

Uncontrolled high blood pressure (hypertension)

Unexplained protein in the urine

What Causes Polycystic Kidney Disease?

The cause of autosomal dominant polycystic kidney disease (ADPKD) is a genetic mutation of one of two
genes affecting kidney development and function. If one parent has the disease, there is a 50% chance
they will pass it on to their children.

How Is Polycystic Kidney Disease Diagnosed?

Polycystic kidney disease is typically diagnosed using imaging studies such as:

Ultrasonography

Computed tomography (CT)

Magnetic resonance imaging (MRI)

Magnetic resonance angiography (MRA)

Other diagnostic testing may include:

Blood tests for kidney function and electrolytes

Complete blood cell count (CBC)

Urine tests, including urine protein and urine albumin

Uric acid level tests

Genetic testing may be indicated for family members or offspring of symptomatic patients. This is
especially important in family members of patients who may be considered as a kidney donor.

Intracranial aneurysms occur twice as often in patients with ADPKD compared to the general population.
For this reason, patients with ADPKD should be screened for signs of intracranial aneurysms if surgery is
planned, if there are neurologic symptoms, or if the patient experiences any suspected signs of stroke.

QUESTION

The only purpose of the kidneys is to filter blood.

See Answer

What Is the Treatment for Polycystic Kidney Disease?

Polycystic kidney disease often can lead to kidney failure, so treatment for ADPKD is aimed at slowing
kidney function decline and includes:

Lifestyle modification

Reduce sodium intake

Increase fluid intake

Avoid contact sports in which direct trauma can cause internal bleeding
Medications

Blood pressure medications

Angiotensin-converting enzyme (ACE) inhibitors

Angiotensin II receptor blockers (ARBs)

Treatment of urinary tract infections (UTIs)

Ciprofloxacin, trimethoprim-sulfamethoxazole, clindamycin, and chloramphenicol

Pain management

Avoid nonsteroidal anti-inflammatory drugs (NSAIDs)

Surgery may be necessary for large cysts

Tolvaptan (Jynarque) used to slow kidney function decline in adults at risk of rapidly progressing ADPKD

Renal replacement therapy for end-stage renal disease (ESRD)

Hemodialysis

Peritoneal dialysis

Kidney transplantation

Management of intracranial aneurysms

Surveillance of aneurysms is necessary because treatment in patients with ADPKD is complicated

What are the Risks and Complications of Polycystic Kidney Disease?

If not well-managed, polycystic kidney disease may progress more rapidly, leading to end-stage renal
disease (ESRD), which requires renal replacement therapy such as:

Hemodialysis

Peritoneal dialysis, or

Kidney transplantation
Intracranial aneurysms are more common in patients with polycystic kidney disease and can cause
complications such as:

Headaches,

Transient ischemic attacks (TIAs, or “mini strokes”)

Hemorrhagic strokes

Vision problems

What Is the Life Expectancy for Polycystic Kidney Disease?

Life expectancy depends on the severity and the progression of the disease to end-stage renal disease
(ESRD). Patients who develop renal failure early in their lives will have more complications and a shorter
life span. Most patients do not begin to develop problems until their 30s, and if the condition is well-
managed can live a near-normal lifespan. Patients who receive kidney transplants can also increase their
life expectancy.

Can You Prevent Polycystic Kidney Disease?

Since polycystic kidney disease is a genetic disorder, it cannot be prevented. Once a patient is diagnosed
with the disease, symptoms and complications may be slowed if the illness is well managed.

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References

A Picture Guide to Kidney Stones

Reviewed By: Charles Patrick Davis, MD, PhD

Reviewed on 7/1/2021

What are kidney stones?

Kidney stones are small masses of salts and minerals that form inside the kidneys and may travel down
the urinary tract.

Kidney stones are small masses of salts and minerals that form inside the kidneys and may travel down
the urinary tract. Kidney stones range in size from just a speck to as large as a ping pong ball. Signs and
symptoms of kidney stones include blood in the urine, and pain in the abdomen, groin, or flank. About
5% of people develop a kidney stone in their lifetime.

What causes kidney stones?

The kidneys regulate levels of fluid, minerals, salts, and other substances in your body.
The kidneys regulate levels of fluid, minerals, salts, and other substances in your body. When the
balance of these compounds changes, kidney stones may form. There are four types of kidney stones,
each made of different substances. Uric acid and cystine are two compounds that may comprise kidney
stones. Factors known to increase the risk of kidney stones include dehydration, family history, genetics,
and the presence of certain medical conditions. Having one or more family members with a history of
kidney stones increases the risk of the condition.

Who is likely to develop a kidney stone?

The rate of people who develop kidney stones is increasing in the U.S.

The rate of people who develop kidney stones is increasing in the U.S. The reasons for the trend are
unknown. The prevalence of kidney stones was 3.8% in the late 1970s. In the late 1980s and early 1990s,
the number rose to 5.2%. Caucasian ethnicity and male gender are associated with higher rates of
kidney stones. Men tend to develop kidney stones in their 40s through 70s; rates increase with age.
Women are most likely to experience kidney stones in their 50s. A person who has suffered from one
kidney stone is more likely to develop others.

What are symptoms of kidney stones?

any kidney stones are painless until they travel from the kidney, down the ureter, and into the bladder.

Many kidney stones are painless until they travel from the kidney, down the ureter, and into the
bladder. Depending on the size of the stone, movement of the stone through the urinary tract can cause
severe pain with sudden onset. People who have kidney stones often describe the pain as excruciating.
The lower back, abdomen, and sides are frequent sites of pain and cramping. Those who have kidney
stones may see blood in their urine. Fever and chills are present when there is an infection. Seek prompt
medical treatment in the event of these symptoms.

How are kidney stones diagnosed?

Kidney stones are diagnosed by excluding other possible causes of abdominal pain and associated
symptoms.

Kidney stones are diagnosed by excluding other possible causes of abdominal pain and associated
symptoms. Imaging tests including an X-ray called a KUB view (kidney, ureter, bladder), or a helical CT
scan are often used to confirm the diagnosis of kidney stones. Although the amount of radiation
exposure associated with these tests are minimal, pregnant women and others may need to avoid even
these low levels of radiation. In these cases, an ultrasound may be used to diagnose the kidney stone.
What is the treatment for kidney stones?

Most people with kidney stones are able to pass them on their own within 48 hours by drinking plenty
of fluids.

Most people with kidney stones are able to pass them on their own within 48 hours by drinking plenty
of fluids. Pain medication can ease the discomfort. The smaller the stone, the more likely it is to pass
without intervention. Other factors that influence the ability to pass a stone include pregnancy, prostate
size, and patient size. Stones that are 9 mm or larger usually do not pass on their own and require
intervention. Stones that are 5 mm in size have a 20% chance of passing on their own while 80% of
stones that are 4 mm in size have a chance of passing without treatment.

What is the treatment for stones that do not pass on their own?

Lithotripsy is a procedure that uses shock waves to break a kidney stone into smaller pieces that can be
more easily expelled from the body.

Lithotripsy is a procedure that uses shock waves to break a kidney stone into smaller pieces that can be
more easily expelled from the body. The device used for this procedure is called a Lithotripter. Kidney
stones can also be removed surgically. A percutaneous nephrolithotomy is a procedure in which a
kidney stone is removed via a small incision in the skin. A kidney stone may also be removed with a
ureteroscope, an instrument that is advanced up through the urethra and bladder to the ureter.

How can kidney stones be prevented?

The best way to avoid kidney stones is to prevent the most common cause – dehydration.

The best way to avoid kidney stones is to prevent the most common cause – dehydration. You are
adequately hydrated when your urine is light yellow. Most people require between 8 to 10 glasses of
water per day. Scientists are studying grapefruit juice and other drinks high in citric acid, which may help
prevent the most common type of kidney stone.

What are risk factors you can control?

Diet is a factor in some cases of kidney stones. A dietician can recommend foods to reduce the risk of
kidney stones.

Diet is a factor in some cases of kidney stones. A dietician can recommend foods to reduce the risk of
kidney stones. Higher than recommended amounts of vitamin D, vitamin C, salt, protein, and foods
containing high oxalates (dark green vegetables) may increase the risk of stone formation. Eating a low-
protein, low-sodium diet with adequate calcium decreases the chance of developing stones. A balanced
vegetarian diet that includes dairy might offer your body the best protection against kidney stones.

Learn about additional risk factors you can control.

Excess weight is linked to kidney stones. In one study, weight gain from early adulthood on was linked to
an increased risk of stone formation.

Excess weight is linked to kidney stones. In one study, weight gain from early adulthood on was linked to
an increased risk of stone formation. Other factors linked to kidney stone risk were increased waist
circumference and high body mass index (BMI). Physical inactivity may increase risk. Certain medications
such as acetazolamide (Diamox) and indinavir (Crixivan) are linked to kidney stone formation.

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