Prevention of Polycystic Kidney Disease
The organs and processes that are responsible for homeostasis (equilibrium of physiologic processes) are crucial for life. Any of them that become dysfunctional can become life-threatening, and the kidneys are major participants in this balance. The severity of kidney dysfunction that comes with polycystic kidney disease (PKD) will eventually eliminate the kidneys’ contribution to homeostasis and require replacement via dialysis or kidney transplant.
Prevention of PKD is impossible due to its genetic inheritance. Instead, the concept of prevention is based on:
- Delay of end-stage renal failure (ESRF)
- Mitigating the morbidities that accompany PKD, such as anemia, fluid and electrolyte imbalances, hypertension, cardiac disease, hepatic and pancreatic cysts, and malignancy.
Much of the treatment of PKD, such as vasopressin antagonists, somatostatin agonists, increased fluid intake, and low sodium diet are also as preventative as they are therapeutic, thought to slow the pace of the deterioration in kidney function.
The “extra-renal” (outside of the kidney) problems associated with PKD are mitigated by preventative strategies:
- Antihypertensive and statin medications should be used to prevent or decrease the cardiovascular disease seen in PKD also weight reduction and smoking cessation.
- Cerebral aneurysm: The most serious complication of PKD, should be addressed before any rupture, which causes hemorrhagic stroke. Poorly controlled hypertension, smoking, heavy alcohol consumption, stimulants, illicit drug abuse, and excessive exertions should all be avoided until which time surgical intervention is warranted to prevent rupture and stroke.
- The pain of hepatic cysts can be prevented by drainage via ultrasonographic guidance.
- Echocardiography: Can diagnose coronary aneurisms and other cardiac disease early to prevent serious cardiac events that contribute to the mortality of PKD.
- Vigilance for malignancy can prevent late-stage unexpected consequences of cancer, the risk of which is increased with PKD.