Rachel Alevy, Laura Greifner, Chelsea Thompson, Sari Warren

Polycystic Kidney Disease (PKD)

Cited in: http://www-medlib.med.utah.edu/WebPath/LIVEHTML/LIVER047.html

Symptoms

• Blood in the urine (may be visible only by microscopic examination)
• Repeated kidney infections
• A mass in the abdomen
• Hypertension
• Pain in the lower back
• Frequent urination
• Increasing fatigue and weakness
• Headache
• Bad breath
• Nausea,vomiting or diarrhea
• Fluid retention, esp. swelling around the ankles or eyes
• Shortness of breath
• Chest pain
• Itching skin
• Cessation of menstruation (in women of child-bearing age)

Causes

• PKD is an inherited disease; there is no known cause.

Effects on Body Systems

PKD may cause various effects on different human body systems. Here are a few ways that the systems are affected.

Because the kidney is the major organ of the excretory system, polycystic kidney disease has many negative effects on the excretory system, such as blood in the urine or frequent kidney infections. Of course, a severely affected kidney may fail, causing frequent urination or fluid retention.

Hypertension is commonly seen in PKD patients. Hypertension occurs when muscles in the arteries expand and contract in abnormal ways, restricting blood flow to certain areas of the body. In this way, hypertension affects both the circulatory and musculatory systems.

Since the kidney often grows to enormous sizes when affected by PKD, other organs are often prevented from doing their individual jobs. For instance, in children especially, the kidney keeps the respiratory system from working properly by occupying space needed by the heart and lungs.

Children who have the recessive form of PKD may have portal hypertension. This is caused by scarring in particular areas of the liver. It blocks blood flow to the liver; causes abdominal swelling; enlargement of the spleen; and increased risk of bleeding from enlarged abdominal blood vessels. For individuals with portal hypertension, a surgical procedure rerouting blood around the liver may be necessary.

Treatment

When total kidney failure occurs, there are two possible courses of action:

• Dialysis treatment, during which the patient is attached to a "fake kidney" 2-3 times a week for 8-9 hours each time. The dialysis machinem simualtes the process of the kidney, cleaning out impurities in the blood so that the amount stays at a healthy level.
• Or, a kidney transplant, in which the patient's kidney is replaced with a functioning kidney from a compatible donor, preferably a family member.

Links to Polycystic Kidney Disease Websites

• National Kidney and Urologic Diseases Information Clearinghouse
• National Kidney Foundation
• Vanderbilt's PKD Website
• Renal Cystic Disease
• Hepatic Pathology

Other Links

• American Association of Kidney Patients
• Kidney Dialysis Foundation

Accomodations

• Different accommodations must be made for different stages of the illness. In less extreme cases, diet and lifestyle changes must be made. In more extreme cases, those which involve kidney failure, either dialysis and/or kidney transplants may be necessary.
• Changes in lifestyle and diet may be necessary with PKD. After consultation with a doctor, diet changes may include a low salt and low protein diet. It may also be necessary to take iron and multiple vitamin supplements to the diet. It is also recommended to drink at least 8 glasses of fluid a day.
• If medication is necessary, which it is often not, then antibiotics may be taken to prevent infection or possibly antihypertensives to control high blood pressure.
• The recommended activity level for a not-so-serious case of PKD is about the same as normal. However, it is recommended that one take short, frequent rest periods during the day.
• For more extreme cases of PKD, a transplant might be needed. This would require finding a donor, or an organ, having that donor tested, and taking medications to lower the possibility of organ rejection, along with the operation and follow-up visits. Sometimes, in the time leading up to a transplant, or before a donor is found, dialysis is needed to keep the patient functional.
• Dialysis is an accommodation that many with PKD might have to make. Dialysis conditions vary, but in most cases, there is a home dialysis machine, and dialysis needs to happen 2-3 times each week, taking 8-9 hours each time. Fortunately, most home dialysis patients find it possible to receive dialysis while they sleep, so it takes as little time as possible out of their day. Sometimes, patients must be hospitalized to receive dialysis.

Works Cited

• Beck, Laurence H. "Kidney." World Book Multimedia Encyclopedia. 1997 ed.
• Bunch, Bryan, ed. Diseases (Vol. 6). USA: Scientific Publishing, 1997.
• Gabow, Patricia A., and Jared J. Grantham, ed. Q&A on PKD. Kansas City, MO: PKR Foundation, 1994.
• Griffith, H. Winter. The Complete Guide to Symptoms, Illness and Surgery. The Putnam Berkely Group, Inc. 1995.
• McAleer, Neil. The Body Almanac. Garden City, NY: Doubleday & Co., Inc., 1985.
• McGrath, Mary. "Kidney Patients Have New Friends Polycystic Disease Support Group Forms." Omaha World- Herald. 24 February 1998.
• Pike, Christopher. Weekend. New York, NY: Scholastic Inc., 1986
• Silverstein, Dr. Alvin, Virginia Silverstein, and Robert Silverstein. The Excretory System. Canada: Fitzhenry and Whiteside Ltd., 1994.
• Stein, Sara The Body Book. New York, NY: Workman Publishing Company, Inc., 1992.