Polycystic Kidney Disease

Treatment

Mayo Clinic has developed a comprehensive team approach to managing PKD, involving:

1. Genetic counseling
2. Maximizing medical management in an effort to extend the life of the kidneys
3. Early detection and treatment of complications
4. Multidisciplinary approach to manage complex clinical problems, such as massive polycystic liver disease and chronic disabling renal pain
5. Basic research to understand how mutations in the PKD genes cause cyst development in the kidneys and the liver, as well as hypertension and aneurysms
6. Clinical trials of novel medications aimed at delaying the progression of the disease
7. Appropriate referral and management of kidney transplantation.

Common symptoms and suggestions for PKD treatment

High blood pressure (hypertension): Most people who have autosomal dominant PKD (ADPKD) develop high blood pressure. Medications are used to help keep blood pressure between 110-120 /65-75 mmHg. Good blood pressure control can lessen the chance of added damage to the kidneys as well as damage to the heart, brain and blood vessels. Controlling blood pressure is also important because hypertension plays a big part in the cardiovascular complications of ADPKD, which are the leading cause of death in people with the disease.

Bladder or kidney infections; kidney stones: People who have ADPKD are more likely to have infections and kidney stones than the general population. Since either infections or kidney stones can damage the kidneys, it is important to seek treatment right away. Most infections can be treated with antibiotics.

Kidney pain: Many people who have ADPKD will experience kidney pain at some point. This pain is usually short-lived and caused by a problem such as bleeding into a cyst, bleeding into the urine, passage of a kidney stone or infection of a cyst. Controlling blood pressure and avoiding trauma may help prevent bleeding episodes. A healthy diet and high fluid intake may help prevent kidney stone formation. Early treatment of urinary tract infections may also help prefect infection of cysts.

Some people experience pain due to the distortion of the kidney by large cysts. If the pain is caused by a small number of cysts, it may be possible to remove the fluid from the cysts using a small catheter placed through the skin. Afterwards, the cysts can be injected with a substance that keeps fluid from re-accumulating. If the pain is caused by a large number of cysts, a surgical procedure to remove the walls of the cysts may be helpful. While the need for surgical treatment is rare, surgery is successful at relieving pain in 70 percent of patients who undergo the procedure. Other treatment options for chronic kidney pain associated with PKD are being developed at Mayo Clinic.

Kidney failure: Kidney failure occurs when the kidneys can no longer do their job. Symptoms of kidney failure include decreased energy level, loss of appetite, weight loss, nausea and/or vomiting, itching, shortness of breath, depression and difficulty thinking clearly. Kidney failure is treated with dialysis or kidney transplantation.