One bitter cold Friday night in February 2008, I had just finished perfecting my makeup for the winter dance at my school. Upon reaching the door to catch my ride, my father stopped me and said he had to tell me something before I left. He explained that day, his doctor diagnosed him with polycystic kidney disease.
I, distracted by my sparkly dress and the car waiting for me outside, simply asked, “What does that mean?” He responded with, “I’m not entirely sure.”
I thought about what my father said throughout the entire dance. Was he dying? Was he in pain? Did he need a transplant?
From that day forth, he became an expert on his condition and taught me and my family everything there is to know.
The kidneys, as we learned in chapter 15 of our textbook, are located against the dorsal body wall between T12-L3 vertebra. The kidneys function in maintaining purity of internal fluids, eliminate nitrogenous wastes, produce erythropoietin and renin, and convert vitamin D into active form (Marieb, 2018).
Polycystic kidney disease (PKD) is an inherited, progressive condition. People with PKD suffer from multiple fluid-filled, non-cancerous cysts that uncontrollably form within the kidneys through build-up of secreted fluid. The cysts cause the kidneys to enlarge overtime, which is painful and uncomfortable. Cysts grow any size and can burst, which is an excruciating experience often involving pyuria and hematuria. This condition is unfortunately chronic and eventually leads to kidney failure.
There are two forms of PKD, autosomal dominant (ADPKD) and autosomal recessive (ARPKD). ADPKD “affects approximately 1 in 400-1000 live births while the ARPKD occurs in approximately 1 in 10,000-20,000 live births” (Stawicki & Lombardo, 2017).
The PKD Foundation gives a great visual for understanding the severity of this disease. A healthy kidney is about the size of a fist and weighs 1/3 of a pound. People with PKD can have kidneys enlarged to the size of a football, weighing up to 30 pounds each. Cysts can range from the size of a pinhead to the size of a grapefruit.
Cysts can appear on the surface of the kidney and cause no harm. Cysts formed by PKD are different and cause trouble by forming within the kidney itself. PKD cysts can the block the flow of urine causing hydronephrosis (kidney swelling) and/or grow so large/numerous that they simply take over the kidney, thus disrupting normal kidney function and leading to kidney failure.
A few symptoms of PKD include (Mayo Clinic):
• High blood pressure
• Back or side pain
• Increased size of abdomen due to enlarged kidneys
• Blood in the urine
• Kidney Stones
• Kidney Failure
• Urinary tract or kidney infections
While PKD targets the kidneys, other parts of the body can also be affected. Cysts on the liver, pancreas, and intestinal walls are common side effects. Valvular heart disorders and coronary artery and cerebral aneurysms also have been reported in patients with PKD (Stawicki & Lombardo, 2017). High blood pressure is also common, effecting the cardiovascular system.
PKD is diagnosed through an MRI, a CT scan, or an ultrasound. A CT scan often reveals a “moth-eaten appearance” of the kidneys “due to cysts that displace functional tissue” (Stawicki & Lombardo, 2017).
There is no cure for polycystic kidney disease. Over-the-counter pain medicine and balanced diet manage symptoms, but for later stages, “50%-75% of patients with autosomal dominant PKD require renal replacement therapy (dialysis or transplantation)” by age 75 (Stawicki & Lombardo, 2017).
The past 10 years have been tough for my whole family. My father is in constant pain and needs to sit/lie down often throughout the day. He is on all sorts of pain management medications and follows a low-protein, low-salt diet to help his kidneys. Through the pain, my dad still works, exercises, cooks, drives, and enjoys life. You would never know he is in pain unless you knew his condition or he told you. He refuses to let this stop him from living fully and happily. He plans on avoiding dialysis and/or transplant if possible. He is handling his condition well and has no plans to back down, and I couldn’t be prouder.
PKD Foundation. “What is PKD?” Retrieved October 22, 2018, from https://pkdcure.org/what-is-pkd/
Marieb, Elaine Nicpon. “Chapter 15: The Urinary System.” Essentials of Human Anatomy & Physiology. Eleventh ed. San Francisco: Pearson/Benjamin Cummings, 2018. 511-512. Print.
Stawicki, S., & Lombardo, G. (2017). Polycystic kidney disease. International Journal of Academic Medicine, 3(3), 72. Retrieved from https://link.galegroup.com/apps/doc/A537799546/AONE?u=googlescholar&sid=AONE&xid=7d4b27d5