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Polycystic Kidney Disease

Polycystic Kidney Disease: PKD

– an inherited disorder in which fluid cysts develop in the nephrons

• In the dominant form- only few nephrons have cysts.
• In the Recessive form-100% of nephrons have cysts from birth.
• Kidney tissue eventually replaced by nonfunctioning cysts, which look like cluster of grapes-kidneys grossly enlarged.
• Each cystic kidney may enlarge to 2-3times normal size (may become football size)
• Most clients with PKD have high blood pressure.
• The cause of high blood pressure is said to be related to ischemia from the enlarging cysts.
• As the renal blood flow decreases, the renin-angiogenesis system is activated, raising blood pressure

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)
– Berry Aneurysm causes severe headaches, with or without vision changes

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.