Polycystic Kidney Disease

A chronic genetic disorder, polycystic kidney disease (PKD) affects over 500,000 individuals in America; and there is no cure. The disease is marked by an abnormal growth of fluid-filled cysts which form in the kidneys and nephrons, vessels that filter toxins and waste products from the body to produce urine. Cysts can eventually grow so large that the viability of normal tissue is severely compromised and the organ ceases to function. As part of the urinary system, the kidneys consist of two identical organs shaped like a fist, located at the back of the abdomen. The organs filter the blood and are crucial to proper elimination of waste products and the survival of life. People who suffer from chronic PKD may experience hypertension, or high blood pressure; frequent urinary tract infections; kidney stones; brain aneurysms; diverticulosis; and hematuria, among other symptoms. Since there is no cure, nephrologists and physicians can only help patients manage the disorder.

The potential for people with polycystic kidney disease to develop hypertension, or high blood pressure, places them at risk of stroke, cardiovascular disease, and organ failure. High blood pressure is a result of blood pulsating through vessels at an abnormal force. However, hypertension can be controlled with medication, diet and exercise. Kidney stones, though painful, can also be extracted surgically. However, hematuria causes severe bleeding, anemia and chronic fatigue; and the loss of blood may necessitate transfusion. Patients with diverticulosis develop tiny sacs in the colon and may have to be hospitalized as the bowels become impacted and infected. Cysts may also form in other parts of the body, resulting in other disorders which may have to be addressed and treated. "The thief cometh not, but for to steal, and to kill, and to destroy: I am come that they might have life, and that they might have it more abundantly. I am the good Shepherd: the good Shepherd giveth His life for the sheep" (John 10:10-11).

There are three types of polycystic kidney disease: acquired, autosomal dominant, and autosomal recessive. People with acquired cystic kidney disease usually have experienced chronic disorders over a long period of time and may have developed the disease after being on long-term dialysis. Accounting for 90 percent of cases, autosomal dominant disorders are those which are inherited. Since the disease is progressive, patients may be unaware of the condition until they are 30- or 40-year-old adults. Autosomal recessive PKD, though rare, can develop in the fetus and go undetected until health issues manifest. Symptoms of the disorder, which may appear in later life, include pain in the back and flank, persistent headaches, blood in the urine, and chronic urinary tract infections. Polycystic kidney disease is difficult to detect without an ultrasound of the kidneys and other organs, along with reviewing a history of family members who may have had the condition. Nephrologists can also study a patient's genes to detect autosomal dominant or recessive markers which would indicate the presence of PKD.

Treatment for polycystic kidney disease is limited to management of pain, high blood pressure, and infection. Physicians will prescribe drugs for managing pain that will not cause further damage to organs; while antibiotics are used to treat chronic urinary tract infections. Nearly half of people affected with PKD will have to endure a lifetime of dialysis, as kidney mass is replaced with cysts and the organs cease to function. Transplant surgery is another option in advanced cases. Hemodialysis utilizes an artificial kidney machine to filter and cleanse an individual's blood. Doctors place a permanent tube, or port, in the patient's leg or arm which enables them to be hooked up to the hemodialysis machine. The blood is pumped out of the body and through the machine, where it is filtered and cleansed; then returned back into the body via specialized tubing. Most patients must undergo the procedure two or three times per week and adhere to a strict diet, fluid intake, and exercise program.

Patients with advanced polycystic kidney disease may also experience a better quality of life with peritoneal abdominal dialysis, a process which utilizes the abdominal cavity to cleanse the blood and body of toxins. Peritoneal patients have permanent tubes inserted into the stomach, from which a saline dialysis solution can be poured from a portable machine. The solution performs the work of the kidneys, eliminating waste and re-circulating clean fluid through the stomach, and drained. People with polycystic kidney disease who elect to use peritoneal dialysis must filter the body every twenty-four hours. Patients can go through the procedure at night while asleep and alleviate the stress of having to go to the clinic for treatment. While dialysis prolongs life, there are side effects. Some individuals experience fatigue and nausea after the procedure; infections can develop at the port or site of entry; the body can retain fluid; and the skin may become darker. The inability of the kidneys to properly filter impurities may also make patients prone to skin rashes. Patients who fail to adhere to strict dietary requirements also run the risk of raising fluid levels, which hampers dialysis.

Candidates for a kidney transplant are individuals who have developed complications with dialysis or suffer from advanced polycystic kidney disease. End stage renal disease, or ESRD, affects those whose organs have ceased to function. Transplant patients may have a long wait for a suitable organ if a donor match cannot be found. Relatives, friends, and spouses may volunteer to donate an organ as long as the blood type and condition of the organ are compatible with the patients. In spite of a devastating diagnosis of PKD; researchers, nephrologists, and biologists are hard at work on improving treatment and eliminating the causes of genetic disorders.

Diabetic Kidney Disease

The problem of diabetic kidney disease is a very serious one for those who must deal with the impact of not one but two major threats to health and well being. When the kidneys are functioning properly, waste products are filtered out of the blood. The millions of blood vessels that the kidneys contains act as a very effective filtration organ for the body. But when these vital filters fail to function correctly, serious and life threatening issues can arise. The connection between the kidneys and diabetes should be understood by anyone who must deal with the illness. Left untreated, diabetes can do serious damage to the kidneys. When the blood sugar levels in the bloodstream are too high, the kidneys will really feel the strain. The filtering abilities of these vital organs can become compromised. The presence of protein in the urine is an indicator of a problem that calls for immediate treatment. If caught early, there are a number of treatments that can prevent future damage to the kidneys. Dealing with diabetic kidney disease is not a hopeless cause. Attention to diet and the right medications can prolong the life of damaged organs and help to keep symptoms under control.

All patients who struggle with diabetes will not necessarily have to deal with diabetic kidney disease. Three things that can make a difference as to whether or not a specific diabetic individual will get kidney disease. These factors are genetics, the control of both blood pressure and the control of blood sugar. If these two factors are kept under control, there is a greater chance that the patient will not face diabetic kidney disease. The kidneys are very hardworking organs. If one group of capillaries is not pulling its weight, other capillaries will compensate. For this reason, an individual may not exhibit any symptoms of serious illness until the organs are loosing most of their ability to function. If an individual is feeling weak, is finding it hard to concentrate, can't sleep, is experiencing digestive problems or has lost their appetite, this may indicate a problem with the kidneys. A regular physical check up can pinpoint health issues before they become major problems. If there is protein in the urine, the physician may want to investigate the possibility of kidney problems. This is also true if blood tests show waste products in the bloodstream. Patients with diabetes will require particular attention to symptoms such as these.

The presence of high blood pressure can have a major negative effect on those who suffer from diabetic kidney disease. Individuals who have been diagnosed with hypertension seem to have a higher likelihood of developing problems in the kidneys, particularly if diabetes is also present. If the kidneys are already diseased, high blood pressure can accelerate the damage that the illness can do. Two numbers are used in recording blood pressure. The first number, called the systolic pressure, is a measurement of the pressure on the arteries while the heart is beating. The diastolic measurement, which is the second number, represents the pressure on the arteries that occurs between heartbeats. Patients with diabetes should keep their blood pressure lower than one thirty over eighty. Hypertension does not cause diabetes, but can cause or contribute to problems with the kidneys. Untreated high blood pressure in patients with diabetes can result in damage to the kidneys. For this reason, taking medications that can control blood pressure is very important for diabetic individuals. The Bible tells believers that it is very important that they love one another. "A new commandment I give unto you, That ye love one another; as I have loved you, that ye also love one another." (John 13:34)

One way to prevent diabetic kidney disease is to keep blood sugar levels within healthy ranges. Keeping blood sugar under control can greatly decrease a patient's chance of damage to the kidneys. In some cases, well controlled blood sugar levels have even succeeded at reversing kidney disease. Blood pressure is also a very important consideration. If illness in the kidneys is present, high blood pressure can quickly make the condition much worse. Methods of successfully keeping high blood pressure under control include medication, weight loss, controlling salt intake, a habit of regular exercise, giving up or not starting smoking, and staying away from alcohol. If blood pressure medications are the chosen option, a physician will make sure that the drugs that are prescribed will not interfere with any drugs that are taken to control diabetes. Some diabetic kidney disease patients may also show improvement by eating a diet that is low in protein. This is due to the fact that the kidneys must work harder if a diet is rich in protein.

If diabetic kidney disease has progressed to a life threatening level, the kidneys may have lost all ability to do their job. There are two options when this is the case, dialysis or a kidney transplant. A dialysis machine will clean the blood in the same way that the kidneys do. Dialysis can be accomplished through two different methods, hemodialysis and peritoneal dialysis. Transplants are as likely to succeed for those who must deal with diabetes as those who do not. There was a time when physicians were hesitant to offer either dialysis or transplants to patients with diabetes due to the poor prognosis that once existed. But with better ways to keep diabetes under control, these life saving options are no longer denied to diabetic individuals.





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