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Polycystosis of kidneys


Polycystosis of kidneys — an inborn disease at which in both kidneys appear and gradually cysts increase that leads to an atrophy of the functioning parenchyma. Treats hereditary anomalies of development and often occurs at members of one family. The disease during life progresses, is most often shown and diagnosed at the age of 20 —-40 years, but sometimes it is found in children, at advanced age.  

Symptoms of the Polycystosis of kidneys:

Usually the disease for many years proceeds asymptomatically. The polycystosis can be found accidentally at inspection, on operation or even on opening. It is explained by small typicalness of symptoms early stages of a disease. When the mass of the functioning parenchyma considerably decreases, broken concentration ability of kidneys, patients note a polyuria and thirst, and then deterioration in appetite, decrease in working capacity, dull aches and feeling of weight in lumbar area, a headache develop. These most frequent subjective signs of a polycystosis of kidneys are supplemented with objective data. The polyuria sometimes reaches 3 — 4 l/days. Urine colourless, low relative density. The nocturia and an isosthenuria are observed. The proteinuria and daily loss of protein are minimum; also the cylindruria is a little expressed. In an urocheras constantly find erythrocytes, also the gross hematuria is observed. Sometimes the gross hematuria has character of profuse, life-threatening renal bleeding. The leukocyturia often testifies to the accompanying infection sometimes leading to the attack of pyelonephritis and suppuration of cysts. In these cases temperature increases (sometimes with a fever), nephralgias amplify, intoxication accrues. At a palpation the increased, hilly, dense and painful kidney is probed.  
    The polyuria promotes removal of products of exchange, and long time of an azotemia can not be, but eventually azotovydelitelny function of kidneys is broken and there is an azotemia. During this period the condition of the patient worsens, appear unpleasant taste in a mouth, nausea. Usually the azotemia at a polycystosis of kidneys progresses slowly, but renal bleeding, suppuration of cysts, and also an injury, surgical intervention, pregnancy and childbirth often accelerate development of an azotemia. Progressing of a disease is promoted by the arterial hypertension which is also often accompanying it which in most cases happens moderate, but sometimes proceeds zlokachestvenno. Arterial hypertension is followed by frustration of a cardiohemodynamics and a hypertrophy of a left ventricle. In late stages of a disease anemia and other symptoms of a renal failure are observed.

Reasons of the Polycystosis of kidneys:

The origin of anomaly is unknown. The pathogeny is caused by defect of embryonic development of tubules which part is transformed to cysts. Kidneys at most of patients are increased, contain a set of cysts of various sizes between which sites of the remained parenchyma in places replaced with connecting fabric are located. Cups and a pelvis are squeezed and deformed. Cysts can suppurate.

Treatment of the Polycystosis of kidneys:

Treatment only symptomatic. Patients have to avoid excessive loadings, long walking and jolty driving, be careful of infections, catarrhal diseases, watch a condition of a nasopharynx and teeth. At emergence of a gross hematuria of the patient has to observe a high bed rest that in most cases provides a bleeding stop without purpose of haemo static drugs. During the attack of the joining pyelonephritis appoint antibiotics and uroantiseptik taking into account reduced function of kidneys. Depression of function of kidneys forces to keep to a diet with restriction of protein and table salt, however food has to be rather caloric and vitamin-rich. Strict restriction of protein is necessary only at plasma creatinine level more than 0,02 g/l. At the expressed arterial hypertension apply antihypertensives, and at a reduced diuresis — diuretic: lasixum, hypothiazid, Aldactonum, etc. Surgical interventions — opening of cysts — is reasonable only at their suppuration. In an end-stage of a renal failure the hemodialysis and renal transplantation can be applied.  
    Forecast. Most often the disease leads to a renal failure in various terms from its beginning.

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