Polycystic Kidney Disease Treatment (PKD)

Leading nephrologists at Herzliya Medical Center conduct the treatment of polycystic kidney in Israel. New methods of diagnosis and treatment of diseases of the kidneys allow specialists to effectively treat polycystic kidney disease symptoms, thus preventing abnormal excretory functioning of the kidneys and the development of complications.

What is polycystic kidney disease?

PKD is, in most cases, a congenital disease (an extremely rare acquired form of polycystic), which is characterized by the presence of renal parenchyma plurality of cavities filled with serous fluid (cysts). The cause of the hereditary polycystic disease is due to genetic mutations, depending on the type of disease that develops in early childhood or during the patient’s lifespan – usually, the first manifestation of PKD diagnosed before the age of 40 years. Cysts vary in size and tend to enlarge. Polycystic kidney disease is often accompanied by the presence of such changes in other internal organs, such as the liver, ovaries, and spleen.

Polycystic Kidney Disease Symptoms

The symptoms for this disease begin to appear due to the decreasing volume of the functional parenchyma, and the pressure exerted by the kidney cysts. The main symptoms of polycystic kidney disease are:

• Symptoms of hypertension – headache, secondary vascular lesions of the brain, visual impairment
• Lower back and lower abdomen pain
• Recurrent infections of the kidneys and urinary tract
• Development of kidney stones and renal colic attacks
• Hematuria – Blood in the urine
• Severe anemia, which develops as a consequence of the hormonal function of kidneys (reduced production of erythropoietin – a hormone involved in the synthesis of red blood cells)
• Signs of increasing intoxication caused by renal failure
• Electrolyte imbalance

Many of the symptoms of polycystic kidney disease are nonspecific, which complicates the early detection of disease. The presence of one or more of the above symptoms requires immediate evaluation by experts to conduct a detailed differential diagnosis.

Polycystic kidney disease diagnosis at HMC

PKD can cause high blood pressure, as the cysts grow, replacing normal kidney functions, which could lead to eventual kidney failure if untreated. Furthermore, one of the serious complications of polycystic is the development of cerebral aneurysms with a high risk of rupture and intracerebral hemorrhage (hemorrhagic stroke). Pregnant women with high blood pressure and with PKD are at risk of developing preeclampsia, which could be life-threatening. It is therefore important to seek medical attention to avoid further complications.

Nephrologists of Herzliya Medical Center thoroughly examine the patient’s medical history and refer him/ her to a series of tests that will allow confirmation of PKD. The main diagnostic procedures include:

• Ultrasonography- this method allows for detecting the presence of cysts, their size, and the status of the renal pelvis and urinary system
• Computer and magnetic resonance imaging in the diagnosis of polycystic kidney disease is essential in order to avoid cancer. Visualization of the internal organs can also identify other (extrarenal) polycystic pockets. CT and MRI of the brain are necessary for the diagnosis of vascular aneurysms
• Fundus examination for the diagnosis of secondary changes caused by hypertension
• Laboratory tests of kidney function (serum creatinine, urea, electrolytes) help analyze in order to diagnose the causes of anemia
• Urine, including bacterial seeding
• Hormonal tests
• Genetic studies for known chromosomal mutations that cause the development of congenital PKD

Polycystic kidney disease treatment at HMC

Polycystic kidney syndrome treatment is indicative and aimed at supporting kidney function and preventing complications. Among the main methods of complex therapy, carried out in this hospital are:

• Blood pressure control using modern antihypertensive drugs to prevent the development of secondary changes
• Analgesic therapy for renal colic
• Application of modern diuretics
• Antibiotic treatment of infectious complications and prophylactic use of long-acting antibiotics
• Correction of electrolyte imbalance
• The use of erythropoietin preparations for the treatment of severe anemia. Also the use of intravenous iron supplementation and red blood cell transfusions when indicated
• A special diet and the use of dietary supplements are important in the prevention of progression of renal failure adapted for patients with renal impairment

Surgical treatment of polycystic kidney disease

Surgical treatment of PKD in large cysts provides significant mechanical pressure on surrounding tissue as well as in the development of irreversible complications. HMC’s specialists practice the following surgeries:

• Draining cysts or the removal of the affected kidney area
• Surgical treatment of aneurysms
• Procedures for crushing kidney stones and removing them from the renal pelvis and ureter
• Surgeries for the preparation of dialysis patients for the procedure
• Kidney transplants

Polycystic kidney prognosis

It is known that PKD is progressive in nature. The prognosis of polycystic kidney disease depends on the severity of the disease, an early diagnosis, and proper treatment choices. Appropriate treatment for the patient is able to prevent the development of renal failure for many years. Patients with severe forms of the disease with irreversible changes and a decrease in filtration capacity require hemodialysis (artificial kidney) and are candidates for a kidney transplant. The key to a favorable prognosis of polycystic kidney disease is timely diagnosis and consultation with a nephrologist specialist at the Urology Department of Herzliya Medical Center.