Treatment of Cystic Diseases of the Kidney in South Africa

Of the cystic kidney diseases, the most common is polycystic kidney disease. This is further sub-classified into two sub-types:

• Autosomal Recessive Polycystic Kidney Disease (ARPKD): This form of the disease is often diagnosed in infants and young children.
• Autosomal dominant polycystic kidney disease (ADPKD): This form of the disease is primarily diagnosed in adulthood.

It is very common to have cystic kidney disease for years without knowing it because it is asymptomatic. Symptoms may include:
• High blood pressure
• Increase in the size of your abdomen
• Frequent urination
• Kidney failure
• Blood in your urine
• Urinary tract or kidney infections
• When to see a doctor
• Back or side pain
• Headache
• Kidney stones

Certain tests can be used to detect the size and number of kidney cysts present. They can also be used to evaluate the amount of healthy kidney tissue. They include:
• Ultrasound exam: A device called a transducer is placed on your body. It emits inaudible sound waves that are reflected back to the transducer. A computer then translates the reflected sound waves into images of your kidneys.
• Computerized tomography (CT) scan: This test is used to see cross-sectional images of your kidneys by a device that projects very thin X-ray beams through your body.
• Magnetic resonance imaging (MRI) scan: This test uses magnetic fields and radio waves to generate cross-sectional views of your kidneys.

There are no specific medical therapies available for the renal cysts themselves, and effective means of preventing the disease have not yet been identified. Therefore, complications of cystic renal diseases, such as hypertension, renal salt wasting, nephrolithiasis, infection, and pain are treated with standard medical therapy.
• High blood pressure: High blood pressure can be controlled through lifestyle changes such as combining a low-fat, low-sodium diet that is moderate in protein and calorie content, increasing exercise, reducing stress and not smoking. Medications are also usually needed to control high blood pressure.
• Pain: This is often controlled with over-the-counter pain medications.
• Complications of cysts: Surgery may be done to drain the cysts.
• Bladder or kidney infections: These should be promptly treated with antibiotics.
• Blood in the urine: Drinking lots of fluids helps to dilute the urine.
• Kidney failure: This is treated with either dialysis or a kidney transplant.
• Liver cysts: Surgery for liver transplant or even removal of part of your may be performed.
• Aneurysms: These are usually treated with surgery.