(1) Clinical manifestations of polycystic kidney disease in general: because of obstruction, cyst infection or bleeding and kidney weight gain traction on the renal vascular pedicle, can cause unilateral or bilateral renal pain. Microscopic or gross hematuria is common and can be quite severe, causing reasons are not clear. When the blood clots or stones downstream may show renal colic. Patients may find themselves with a abdominal mass. Infection (plug war, fever, kidney area pain) is a common complication of polycystic kidney disease. Bladder irritation may be the first symptom, along with the occurrence of renal dysfunction, there may be headache, nausea, vomiting, fatigue, weight loss.
(2) polycystic kidney disease signs: often palpable one or both kidneys, nodular surface sense. Concurrent infection, may have tenderness. 60% to 70% of patients can have high blood pressure, an enlarged heart may then find the evidence. It appears pyelonephritis or cyst infection may include fever. Uremia may have significant anemia and weight loss. Ophthalmoscopy can be found in a typical moderate to severe hypertension change performance.
(3) polycystic laboratory manifestations: anemia caused not only by chronic blood loss, more because of uremia are associated with inhibition of hematopoietic function due. Visible urine proteinuria and gross or microscopic hematuria, pyuria and bacteriuria also is common. Urine concentration function has sexual dysfunction. Renal clearance test may show various degrees of impaired renal function. Approximately one-third of patients with polycystic kidney disease is uremia are found.
(4) X-ray examination of polycystic kidney performance: in abdominal plain film, bilateral renal shadow usually increases, even up to five times the normal size, length of more than 16cm kidney disease should be suspected. When the excretory row tomography venography can help establish the diagnosis, tomography can show multiple cysts transparent. In tomography and retrograde urography film, kidney often increases calyx is very strange forms (such as spider-like deformity): calyx widened, flattened, expanded and often curved around the neighborhood surrounding the cyst. This change does not occur often mild or even on the side of the kidney, thus easily lead to misdiagnosis of cancer or other kidney disease. When the cyst complicated by infection, kidney inflammation around and make kidney Movies As psoas Cinema blurred. Angiography can show small blood vessels around the bend of the cyst and cyst formation itself "negative" image (no vascular distribution).
(5) CT scan: in past non-invasive diagnostic technique for the diagnosis of polycystic kidney disease, CT is the best. Multiple cysts within the cyst fluid filled with a thin wall and increased compared with normal kidneys, making this imaging modality at the time of diagnosis is extremely accurate (95%).
(6) of the renal radionuclide examination: γ- scintigraphy will show increased renal shadow Many avascular "cold spots."
(7) Ultrasound: Ultrasound images for better diagnosis of polycystic kidney disease and renal excretory urography radionuclide examination.
(8) polycystic equipment inspection performance: cystitis cystoscopy can be found, then the urine contains abnormal ingredients. Sometimes you can still see the ureteral orifice spurting. Urography and retrograde ureteral catheterization is rarely used.
Polycystic kidney disease when clinical manifestations occur, the condition can develop very quickly, this disease is usually divided into three phases: the first phase without clinical manifestations of polycystic kidney disease, polycystic kidney disease clinical manifestations Phase II, Phase III uremia . Clinical manifestations of polycystic kidney disease first appeared in pain, often in the waist, but also some patients have back pain in the groin, upper abdomen or lower abdominal discomfort. Cause of the pain may be the renal capsule tension increased pressure on adjacent organs, cysts and bleeding. Few people can renal colic. More than 70% of patients with hypertension, retinal changes associated with hypertension, half of patients with hematuria. May be palpable in the abdomen or waist uneven mass, can be misdiagnosed as liver or spleen.
The common complication of patients with stones and infections can also be complicated by kidney tumors; about one-third of patients with polycystic liver, the spleen may also occur, pancreas and lungs and other cystic lesions; about half of patients with brain aneurysm. Polycystic kidney disease patients eventually develop chronic renal failure, uremia and associated symptoms. Once uremia occur, the prognosis is poor.
Compared with patients PKD1, PKD2 patient's mild, late onset. Clinical diagnosis, associated with polycystic kidney disease in patients with PKD1 average age of 44.8 years, PKD2 was 69.1 years. A smaller number when making a clinical diagnosis of renal cysts. The average life expectancy is longer (PKD2 was 71.5 years, while PKD1 56.0 years), there is a lower risk of developing hypertension and renal failure. Although the PKD2 gene mutation clinical phenotype is usually higher than the PKD1 gene mutation of light, but is caused by mutations in PKD2 polycystic kidney disease are also a serious disease. Its phenotype is caused by PKD1 gene mutation and is similar to patients with PKD1 and PKD2 are irrelevant. Polycystic kidney disease by clinical manifestations must be timely treatment, polycystic kidney disease is generally serious consequences, only more attention to clinical manifestations of polycystic kidney disease, polycystic kidney standard treatment can be effective in preventing the emergence of uremia.
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