Prevention of PKD
Currently there is no treatment that can prevent formation or slow down the growth of cysts in PKD.
Screening of family members and making an early diagnosis before it sets in has several advantages. Early diagnosis provides an opportunity to treat PKD in a better way. Early diagnosis and treatment of high blood pressure prevents development or aggravation of renal failure in PKD. Lifestyle and dietary modification in PKD patients protects their kidney as well as the heart. The major disadvantage of screening is that the person may become very anxious about the disease at a stage when the person neither has the symptoms nor needs any treatment.
PKD is an inherited kidney disease so consider screening of adult family members for PKD.
Why is it not possible to reduce the incidence of PKD?
PKD is diagnosed usually at the age of 40 years or more. Most people have children before this age and therefore it is not possible to prevent its transmission to the next generation.
Treatment of PKD
PKD is a non-curable disease but why does it need treatment?
- To protect the kidneys and delay progression of chronic kidney disease to end stage kidney disease and thereby prolong survival.
- To control the symptoms and prevent complications.
Important measures in the treatment of PKD:
- The patient is asymptomatic for many years after initial diagnosis and does not require any treatment. Such patients need periodic checkup and monitoring.
- Strict control of high blood pressure will slow down the progression of CKD.
- Control of pain with drugs which will not harm the kidney (such as aspirin or acetaminophen). Recurrent or chronic pain occurs in PKD due to cyst expansion.
- Prompt and adequate treatment of urinary tract infections with appropriate antibiotics.
- Early treatment of kidney stones.
- Plenty of fluid intake, provided the person does not have swelling helps in prevention of urinary tract infections and kidney stones.
- Meticulous treatment of chronic kidney disease as discussed in Chapters 10 to 14.
- In a very few patients surgical or radiologic drainage of cysts may be indicated because of pain, bleeding, infection, or obstruction.
Treatment is aimed at delaying progression of CKD and treating kidney infections, stones and abdominal pain.
When should a patient with PKD consult a doctor?
Patients with PKD should immediately consult a doctor if he or she develops:
- Fever, sudden abdominal pain or red urine.
- Severe or recurrent headaches.
- Accidental injury to enlarged kidneys.
- Chest pain, severe loss of appetite, severe vomiting, severe muscle weakness, confusion, drowsiness, unconsciousness or convulsion.
Asymptomatic person with PKD may not require any treatment for many years initially.