7 Suggestions For PKD Treatment
ADPKD (Autosomal Dominant Polycystic Kidney Disease) is the most common hereditary kidney disease characterized by progressive enlargement of renal cysts. Approximately 45% to 70% of ADPKD patients progress to end-stage renal disease (ESRD) before age 65, which is the fourth leading cause of renal replacement therapy. The following are some suggestions of PKD treatment.
1. Early diagnosis of ADPKD
All patients diagnosed with or suspected of ADPKD are recommended to be referred to the department of nephrology for preliminary evaluation, including renal imaging examination. Some patients should also take genetic testing to determine the risk of rapid progression and take appropriate treatment options.
2. Genetic testing
Patients who have been diagnosed with ADPKD based on imaging examination are not required to undergo genetic testing in the selection of treatment options.
3. Renal imaging diagnosis
The preferred diagnosis method for patients with family history of ADPKD is ultrasonic testing. ADPKD is divided into "typical" ADPKD and "atypical" ADPKD by Mayo staging.
Patients without family history of ADPKD can take other imaging testing methods including CT or MRI to diagnose ADPKD especially young patients.
4. Kidney imaging tests to assess the disease progression and prognosis
Baseline assessment of renal size is recommended for ADPKD patients, which is helpful for those who have risk of rapid progression and take appropriate treatment.
For ADPKD patients with typical manifestations, it is recommended to use ultrasound to detect kidney length (KL) and MRI or CT to detect total kidney volume (TKV).
After baseline renal size assessment, not all patients require routine renal size assessment. If repeated assessment of kidney size is required, it is recommended that the frequency of testing be no more than once a year.
5. Assessment of disease progression
Patients testing htTKV are advised to stratify risk of progression according to Mayo staging or other effective clinical tools.
Currently available tkv-based predictive tools are only available for type 1 (typical) patients, who are at risk of rapid progression.Other patients require further clinical evaluation.
Patients who meet any of the following criteria are recommended to be considered at risk of rapid progression: (1) Mayo stage 1C, D or E; (2) bilateral KL > 16.5cm was examined by ultrasonic testing.
Rapid progression markers included: (1) an annual successive increase of > 5% in htTKV by imaging examination, or (2) disease progression (e.g, a rapid decline in eGFR, defined as a decline in eGFR of > 2.5 mL/min/1.73 m2).
6. Non specific treatment
Patients are less than 50 years old, with eGFR> 60 mL/min/1.73 m2 and no obvious cardiovascular diseases are suggested to control blood pressure for 110-75mmHg.
7. Specific treatment
The treatment for PKD should aim for shrinking kidney cysts and stop the secretion of cystic fluid. Here we recommend Chinese medicine treatments including Micro-Chinese Medicine Osmotherapy, Medicated Bath, Medicated Foot Bath, Medicinal Soup, Mai Kang Mixture, Steaming Therapy and Enema Therapy, etc. Chinese medicines can restrain the abnormal activity of renal tubular epithelial cells and lining cells to prevent renal cysts from growing further. They can also increase the permeability of cyst wall and pressure difference inside and outside so that fluid can be drawn out, and then renal cysts will shrink. After one week of treatment, symptoms like back pain, blood in urine and high blood pressure, etc can be relieved greatly. After one month of treatment, your kidney cysts can be shrunk and renal function can be improved.
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***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***