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Clinical manifestations of polycystic kidney disease

May 08, 2017

The size of the kidney was normal or slightly larger, and the number and size of the cysts gradually increased and increased with age. The majority of cases were 40 to 50 years old and the renal volume was increased to a considerable degree. The main manifestations were bilateral enlargement of the kidney, renal pain, hematuria, hypertension and so on.

(1) kidney enlargement:

The development of bilateral renal lesions asymmetry, the size of the difference, to the late two kidney can account for the entire abdominal cavity, the kidney surface has a lot of cloth, so that kidney shaped irregular, uneven, hard texture.

(2) renal pain:

For its important symptoms, often for the back pressure or dull pain, pain, sometimes abdominal pain. Pain may be due to physical activity, walking time is too long, sedentary, etc., can be reduced after bed. The cause of sudden pain in renal hemorrhage, stone movement or infection.

(3) hematuria:

About half of the patients presented with microscopic hematuria, and there were paroxysmal hematuria. Bleeding over a long period of blood clots through the ureter can cause colic. Hematuria is often accompanied by white blood cells and proteinuria, urine protein quantity is less, generally no more than 1.0g/d. Pyuria obviously, renal hematuria increased infection, back pain and fever.

(4) hypertension:

For the common manifestation of ADPKD, approximately half of the patients had hypertension before serum creatinine increased, which was associated with the activation of the renin angiotensin aldosterone system. In the past 10 years, Graham PC, Torre V and Chapman AB have confirmed that the normal renal tissue, cysts adjacent to the stroma and cyst epithelial cells increased renin particles, and increased renin secretion. These are closely related to the growth of cysts and the occurrence of hypertension. In other words, the rapid development of high blood pressure cysts, can directly affect the prognosis.

(5) renal insufficiency:

This disease happen sooner or later renal insufficiency, inpidual cases in adolescence is kidney failure, usually before the age of 40 there is little decline in renal function at the age of 70, about half remain renal function, but the process of hypertension to renal failure is greatly shortened, there are also inpidual patients 80 years of age can still maintain kidney function.

(6) polycystic liver disease:

About 60 of middle-aged patients with ADPKD were found to have polycystic liver disease, after about age 70%. It is generally thought that the development is slower and more than 10 years later. The cyst is lost by bile duct expansion member. In addition, the cyst of the pancreas and ovary may also occur.

(7) aneurysm of the basilar artery:

Concurrent with this hemangioma is 10% to 40%, often due to rupture of hemangioma, further examination of cerebral hemorrhage was found. In addition, thoracic aortic aneurysm and valvular heart disease (such as valvular regurgitation and prolapse) are also more common.

Adult polycystic kidney disease in general in the early symptoms, often with hematuria, hypertension or renal dysfunction, abdominal palpation can be found in the majority of polycystic kidney. Renal function is more slowly progressive decline, high blood pressure, obstruction or pyelonephritis, is an important cause of accelerated renal damage. Autosomal recessive (infantile) polycystic kidney disease in infancy, the clinical rare, mostly in infancy, a small number of mild patients can live to adulthood.

The degree of anemia in this disease is often lighter than that caused by other causes. The reason is that the cyst of the kidney can produce erythropoietin.

 

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