POLYCYSTIC KIDNEY DISEASE

POLYCYSTIC KIDNEY DISEASE

– A cyst develops in the nephron (kidneys)
– It is an inherited disease of the kidneys.

IN THE DOMINANT FORM- ONLY FEW NEPHRONS HAVE CYSTS.
IN THE RECESSIVE FORM-100% OF NEPHRONS HAVE CYSTS FROM BIRTH.

– Cysts in kidneys would look like a cluster of grapes
– Patients would have hypertension. (Due to Renin Angiotensin System)

MANIFESTATIONS IN THE PATIENT:

PAIN IS THE FIRST MANIFESTATION
FLANK PAIN IS DULL, SHARP OR INTERMITTENT

DULL ACHING PAIN- is caused by increase kidney size, from infection from the cyst.
SHARP INTERMITTENT PAIN- is when a cyst is rupture or when a stone is present.

BERRY ANEURYSM
– can occur (bleeding into brain from ruptured intracranial vascular cysts)
– causes severe headaches, with or without vision changes (pay extra attention
to patients with severe headaches, since it can be a sign of a ruptured cyst).

DIAGNOSTIC TESTS:
– renal sonogrophy
– computed tomography
– MRI

INTERVENTIONS:

BE VERY CAUTIOUS IN USING NSAIDS, BECAUSE IT CAN CAUSE BLEEDING
ANTIHYPERTENSIVES AND DIURETIC AGENTS (ACE INHIBITOR, CALCIUM CHANNEL BLOCKER, BETA BLOCKER)
IS USED FOR HYPERTENSION.

If during in the NCLEX exam, it talks about a sharp pain, followed by blood in the urine= it usually is a ruptured cyst.

♣ Berry Aneurysm= main symptom is severe headaches.

♦ Urinanalysis in patients with PKD:

Protienuria
Hematuria
Bacteremia

Protienuria in pt. indicates PKD disease progression.

NSAIDS should be avaoided= it can cause bleeding in pts.

PAIN from PKD- apply dry heat to the abdomen or flank area.

ACE Inhibitors– the best medication to control hypertension (PKD).

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