Polycystic kidney disease

This disease is characterized by the development in the renal parenchyma multiple cysts with serous content of various sizes and in different quantities. Polycystic kidney - disease bilateral, however, the disease process can be expressed in the right and left kidney to a different degree. Polycystic defeat only one kidney is a rare exception.
Polycystic process in kidneys is developing on the ground malformation - badly healed in the embryonic period of the renal tubules blastoma with collective tubes, growing into the parenchyma of the pelvis. Part of dropped tubules become empty, and the other under the pressure of accumulated secret tubular epithelium and related glomeruli Katowice stretched. After such bone cysts in turn and the glomeruli.
As they grow, cysts cause atrophy of the renal parenchyma and reduce kidney function.
Polycystic kidney in most cases enlarged, their surface is uneven. In the section you can see many cavities, a thin layer of the parenchyma, squeezed and stretched in length pelvis and cups (Fig. 57).

cystic kidney
Fig. 57. Cystic kidney. a - appearance; b is on the cut.

Approximately 20% of cases polycystic kidney disease remains asymptomatic throughout life. In other cases, there are pain, kidney failure, hematuria, hypertension. Pain is usually stupid, depend on increasing the kidneys in the volume and on the move due to its weight. Renal failure progresses slowly and unevenly, interspersed with long periods satisfactory kidney function. Developing (due to compression cysts renal vessels) ischemia parenchyma leads to increase in blood pressure (this symptom is observed in more than half of the cases polycystic kidney disease). Hematuria is different intensity, sometimes threatening; the cause - venous stagnation, high blood pressure, the gap cysts.
In addition to bleeding, dangerous complications with polycystic kidney is the juxtaposition of the infection, festering cysts, pyelonephritis. The inflammatory process dramatically affect kidney function, spare capacities are exhausted.
The diagnosis is based on apparently from both sides increased, thick, bumpy kidneys and symptoms of renal failure, haematuria, hypertension. An important diagnostic aid has a retrograde pyelography, which gives a picture of excessive branching, elongation elongation of the cups on both sides (Fig. 58).

polycystic kidney
Fig. 58. Polycystic kidney disease. Bilateral retrograde pyelogram.

The main treatment in patients with cystic kidney conservative. Recommended restricted diet protein and salt, hemostatic agents, antibiotics. However, if the conservative by persists septic phenomena or threatening bleeding, produce surgery - naked kidney and reveal that more cysts. Nephrectomy with polycystic kidney valid only as a last resort, when threatening bleeding or suppuration cysts and septic condition can not be any other means.