Autosomal Dominant Polycystic Kidney Disease Treatment in Delhi, India

Polycystic kidney disease has the following symptoms:

• High blood pressure
• Back or flank pain
• Kidney failure
• Urinary tract or kidney infections
• Blood in your urine
• A feeling of fullness in the abdomen
• Kidney stones
• Enlarged kidneys cause an increase in the size of the abdomen
• Headaches

For the diagnosis of autosomal dominant polycystic kidney disease, certain tests help analyse the size and number of cysts in the kidneys. In addition, they help evaluate the severity of the disease and the amount of healthy kidney tissues remaining. The tests advised include:

• Ultrasound: A painless test that creates images of renal tissues to evaluate for anomalies. The transducer is placed and moved over the abdomen of the kidney area. An ultrasound image of the kidney can be seen on a video screen, and its dimensions are assessed. The cysts can be clearly viewed to understand the disease severity. 
• CT scan: This scan involves lying on a machine bed that takes the patient to a doughnut-shaped device. This device uses X-ray beams to give cross-sectional images of the kidneys for evaluation.
• MRI scan:This test, too, helps obtain 3D images of the kidney. Thereby allowing the doctor to evaluate the condition of the patient.

Treating people with autosomal dominant polycystic kidney disease often aims to improve renal function. Other factors that determine the treatment option are the severity of the disease, the patient's age, condition, and tolerance to the treatment.

Medical Management

The early treatment of autosomal dominant polycystic kidney disease requires managing the associated conditions apart from the disease itself. Medicines that help manage the disease include:

• Blood pressure control: Medicines such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are prescribed to manage high blood pressure.
• Blood sugar control: Medicines that help control high blood sugar in people with diabetic nephropathies, such as metformin, improve insulin sensitivity and lower glucose production in the liver. Glucagon-like peptide 1 (GLP-1) receptor agonists reduce blood sugar levels by slowing digestion and stimulating insulin secretion in response to rising glucose levels. SGLT2 inhibitors limit glucose from returning to the bloodstream, leading to increased glucose excretion in the urine.
• Kidney cyst growth: Tolvaptan therapy is often recommended for adults who are at risk of rapidly progressive ADPKD. Tolvaptan helps slow the rate of cyst growth and improves renal function.
• Pain: Pain with polycystic kidney disease may be excruciating, and need over-the-counter medications to alleviate it. Sometimes, sclerosing treatments are advised for people with constant and unbearable pain. Alternatively, removing the cysts may also be an option for some.
• Bladder or Renal Infections: Immediate treatment of infections is necessary for a patient with polycystic kidney disease. This is because untreated cases may damage the kidney entirely and may lead to sepsis. Antibiotics help treat these infections. Sometimes, longer therapy may be required for complex infections.

Surgical Management

If the kidney disease progresses to kidney failure (end-stage kidney disease), the treatment is focused on either replacing the kidneys or using a dialyser to remove toxins from the body. In addition, the treatment aims at making the patient more comfortable. Some options include:

Kidney Dialysis

This treatment is done to remove waste products and extra fluid from the blood. The two main types of dialysis are:

• Hemodialysis - It is more commonly done and requires regular visits to the dialysis centre about three times a week. Alternatively, a trained caregiver can do dialysis at home for a session of 3 to 5 hours a week. 
• Peritoneal dialysis - This procedure can be done either at home or at a dialysis centre.

Kidney Transplant

In some cases, the best option is a kidney transplant. If a kidney transplant is chosen, the patient's eligibility as a recipient is tested.

Risk factors associated with polycystic kidney disease include the following:

• PKD1 genotype
• Large kidneys
• Black racial background
• Severe and frequent kidney infections
• Hypertension
• Several episodes of gross hematuria
• Multiple pregnancies
• Male gender

Complications that may occur due to polycystic kidney disease are:

• High blood pressure
• Chronic pain
• Growth of cysts in the liver
• Heart valve abnormalities
• Loss of kidney function
• Development of an aneurysm in the brain
• Pregnancy complications
• Colon problems

• Life expectancy with polycystic disease is good. However, as the disease progresses, patients may need dialysis and, eventually, a renal transplant. 

• Know About the Inherited Kidney Diseases!
• Know about the Actual Causes of Kidney Damage
• Know your Kidneys !