Polycystic renal cortex and medulla full because many thin-walled spherical cyst is named, is an autosomal dominant genetic disease, it may be due to the formation of cysts manifold embryonic kidney units and some far connecting tubule mistakes due. Does not occur after birth, a new cyst, but there are cysts will continue to increase, it looks like a bunch of grapes. Bright yellow capsule containing a liquid, when the trauma or complicated by infection, the liquid was bloody. Between cysts normal kidney parenchyma, but also for changes of chronic interstitial nephritis. Lesions often bilateral, unilateral accounted for only 10%. Because cyst oppression renal unit, causing local renal obstruction, affect renal function, often slowly cause renal failure, accounting for 5% to 10% the cause of uremia.
The incidence of polycystic kidney disease, no significant difference between men and women, accounting for 0.2% of the autopsy, but the clinical diagnosis rate is not high, it is often misdiagnosed, the onset of symptoms to diagnosis an average of four years, mainly doctors lack of awareness of the disease . Polycystic general symptoms to appear after age 40, the most common symptoms are flank pain, hematuria, nocturia, approximately 10% of patients with kidney stones, some patients may be due to obstruction caused by stones and renal colic blood clots, most patients will urinary tract infections, urinary frequency, urgency, dysuria, particularly in the use of urinary tract instruments (such as catheterization, cystoscopy, etc.), the especially prone. Usually palpable enlargement of the kidneys. Varying degrees of renal enlargement. Sometimes only one side can reach the kidneys. 75% of patients with hypertension, but few have edema. There are also associated with polycystic kidney, liver, spleen, pancreas, ovary cysts. Laboratory tests can be found in varying degrees of proteinuria, hematuria, anemia can occur late. Has a decisive significance for the diagnosis is established IVP; B Super, CT, X tomography, isotope renal scan can also be used as an important means of diagnosis. Retrograde urography, not a last resort, not the implementation, because it often causes urinary tract infections.
Polycystic kidney disease treatment should be clear: the existing spherical cyst is impossible to disappear. Treatment should first avoid increasing renal impairment factors, such as urinary tract infections, urinary tract obstruction stones or blood clots, hypertension, while avoiding nephrotoxic drugs (such as streptomycin, gentamicin, etc.) and pain medications. Prevention and treatment of urinary tract infection is most important because urinary tract infection may accelerate the deterioration of renal function, but also to cure the infection within the cyst is very difficult, the drug is difficult to achieve an effective concentration within the cyst, it actively prevent its occurrence is significant, especially should be avoided Urinary instruments. Urinary tract infection can be no urinary frequency, urgency, dysuria, and was asymptomatic bacteria in urine, which should be actively sufficient quantity to use broad-spectrum antibiotics such as cephalosporins, and long-term follow-up observations, every 3 to 6 months to do a quantitative bacterial cultures of urine for early detection of urinary tract infections. Secondly, diuretics should be used with caution, because it can reduce the tubular water and sodium reabsorption. Hypertension optional propranolol, captopril, methyldopa like. It should not be too much emphasis on limiting sodium intake, due to the disease itself beneath sodium tendencies. Surgical decompression treatment, can only accelerate the deterioration of renal function, currently not in favor of implementation.
Polycystic kidney disease prognosis: baby died after birth polycystic general uremia, polycystic kidney disease in children each year in a liver disease and uremia died within a few months. Although adult polycystic kidney disease can not be cured, but progress is very slow to uremia, the average life expectancy of patients is about 50 years after the onset of symptoms, the average survival time of 10 years, but a great individual differences, there are many life without clinical manifestations By. Even to the end-stage uremia, but also the implementation of alternative therapies, including hemodialysis, peritoneal dialysis, renal transplantation, the longest of the three survivors have been more than 10 years.
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