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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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