IPLab:Lab 5:Polycystic Kidney Disease
This 64-year-old white man had a history of hypertension, adult-onset diabetes, gouty arthritis, chronic obstructive pulmonary disease (COPD), chronic anemia, bleeding from colonic polyps, and bleeding from gastric ulcers. The patient was in end-stage renal failureRenal failure is the severe reduction of renal function and often leads to reduced urinary output. due to polycystic kidney disease and he required renal dialysis. His mother and a brother both died from renal complications.
His terminal admission was for congestive heart failure and ventricular tachycardia. He underwent a coronary artery bypass grafting (CABG) operation after which he was ventilator-dependent. Two days after the operation he developed pneumoniaIn alcoholics, aspiration pneumonia is common--bacteria enter the lung via aspiration of gastric contents. and died.
The lungs were diffusely consolidatedConsolidation is the filling of lung air spaces with exudate--this is a sign of pneumonia. with some abscessesAn abscess is a collection of pus (white blood cells) within a cavity formed by disintegrated tissue. in the right upper lobe. The kidneys were markedly enlarged. The right kidney weighed 1660A normal kidney weighs 157 grams (range: 115 to 220 grams). grams and the left kidney weighted 1780A normal kidney weighs 157 grams (range: 115 to 220 grams). grams.
Adult polycystic kidney disease occurs in approximately 1 out of 1000 people. A rare autosomal recessive polycystic kidney disease occurs in childhood (perinatal, infantile, neonatal, and juvenile subcategories) but this anomaly is genetically distinct from the adult variety.
People with polycystic kidney disease often develop hypertension, as do many patients with renal disease. Uremic pericarditisPericarditis is inflammation of the pericardium - often with deposition of fibrin. often occurs in people with kidney failure induced uremia.
- What are some of the other congenital anomalies that can be seen in people with polycystic kidney disease?
Asymptomatic polycystic liver disease is seen in 40% of these patients. Cysts can also occur, albeit infrequently, in the spleen, pancreas and lungs. These people also have a 10% to 30% incidence of berry aneurysms in the circle of Willis.
- eMedicine Medical Library: Polycystic Kidney Disease
- eMedicine Medical Library: Cystic Diseases of the Kidney
- Merck Manual: Overview of Cystic Kidney Disease
- Bajwa ZH, Gupta S, Warfield CA, Steinman TI. Pain management in polycystic kidney disease. Kidney Int 2001 Nov;60(5):1631-44.