What is Polycystic Kidney Disease (PKD)
Polycystic kidney disease (PKD) is a fairly rare genetic condition that affects roughly half a million Americans. It has no cure, but at 麻豆高清, rare diseases matter just as much as common ones. NewYork-Presbyterian Hospital and its affiliated nonprofit, The Rogosin Institute, have been named a Center of Excellence by the Polycystic Kidney Disease Foundation.听
In patients with PKD, cysts take over and crowd out normal kidney tissue, says Dr. James Chevalier, Clinical Co-Director of the PKD Center of Excellence. 鈥淢ore than half of the patients who have PKD experience kidney failure by age 60 and need to start dialysis or receive a kidney transplant.听
鈥淧KD is a systemic disease,鈥 Dr. Chevalier continues. 鈥淎s such, it can cause issues in other parts of the body, including aneurysms of the brain, enlargement of the liver with cysts, problems with fertility and heart abnormalities. That鈥檚 why many of our PKD patients are referred to other specialists, in addition to seeing us.鈥听
Genes and genetic testing听
There are several well-known genetic mutations associated with PKD. A child with one parent who has the most common type of PKD, called autosomal dominant PKD, stands a 50-50 chance of inheriting the disease. Weill Cornell鈥檚 Center of Excellence offers genetic counseling and testing for PKD.听听
Symptoms and treatment听
The symptoms of PKD may include:听
- pain, pressure or discomfort in the abdomen or back听
- constipation听
- acid reflux听
- headaches听
- high blood pressure听
- blood in the urine听
- kidney stones听
As for treatments, explains Dr. Chevalier, 鈥渨e start by reviewing your medications. One change we recommend is to switch your birth control method from estrogen-based to non-estrogen-based contraception. That鈥檚 because estrogen is known to fuel the growth of cysts, especially in the liver.鈥听
The PKD team also focuses on decreasing stress on the kidneys, urging patients to:听
- drink water throughout the day听
- avoid taking NSAID medications, such as ibuprofen and naproxen, as much as possible, and to try acetaminophen first for pain听
- work with their doctors to control high blood pressure, diabetes and high cholesterol, and to achieve a healthy weight听
- quit smoking听
Finally, the FDA has approved tolvaptan for the treatment of PKD. 滨迟鈥檚 the only medication to date that has received approval to slow the growth of kidney cysts and the progression of kidney disease. The certified PKD team at The Rogosin Institute prescribes tolvaptan and manages treatment for one of the largest groups of patients taking the medication. Tolvaptan prescribers meet weekly to review every patient receiving tolvaptan therapy, discuss laboratory test results and ensure that follow-up appointments and prescriptions are up-to-date.听
When might a kidney transplant be necessary?听
In the U.S., a person generally qualifies for a kidney transplant when their kidney function is about 20 percent or less. The 20 percent mark is the point at which doctors at The Rogosin Institute encourage patients to add their name to the national transplant list. That being said, 鈥渨e usually advise patients to get a transplant when their kidney function is closer to 10 percent. This means that a lot of preparation and education happen for patients between 20 percent and 10 percent kidney function,鈥 he says.听听听
鈥Our first goal is to keep the original kidneys working as long as possible. Our second goal is to have the patient get a kidney transplant before reaching that 10 percent mark. That way, the测鈥檒l be able to avoid dialysis altogether.鈥听
When the测鈥檙e between 20 and 10 percent kidney function, patients learn about dialysis options so they can make an informed choice regarding a back-up plan for dialysis in case a transplant 颈蝉苍鈥檛 possible within that timeframe. That allows the patient to experience a smooth transition from advanced kidney disease to dialysis, which the测鈥檒l need to do temporarily until the测鈥re able to receive a transplant from either a living or deceased kidney donor, Dr. Chevalier explains.听
A hopeful perspective听
The more patients know about PKD, the more in control they feel. And with control comes hope.听听
There may be no cure for PKD鈥攁t least not yet鈥攂ut there鈥檚 a wealth of available treatments that can improve a patient鈥檚 quality of life for years to come.听听
Learn more about 听and learn more about 麻豆高清鈥檚 kidney transplantation program and the diseases and conditions we treat.