As mentioned, your remaining GFR is around 20ml/min. Your present creatinine level might be around 500umol/L, right? Creatinine is one representative on various metabolic wastes accumulation within body. These things can lead damage to variour organs. I am afraid you now also suffer from Anemia, right? if so, this can well explain your easy tiredness.
PKD damages kidney mainly through cystic pressure, which limits blood flow into and within kidneys. Long term Hypoxic-ischemic state in kidney leads to kidney cell damage and these cells further progress into sclerotic cells. For your present condition, there may have already certain portion of necrotic cells. But with GFR still being above 20ml/min, this portion of necrotic or sclerotic cells could not be very big. For your condition, most of these pressed cells are damaged, once the pressure can be alleviated, there will be sufficient blood and oxygen supply to these cells. And together with proper supporting nutrients, there is still a chance for the reversion of these damaged cells.
You can tell, the key in treating PKD is shrinking these cysts. As mentioned, your both kidneys are enlarged and frankly nearly all kidney cells are involved in pressure or damage. But, relatively speaking, PKD patients can expect a more satifying recovery, for large portion of cells are involved in damage, also large portion of these cells have not gone necrotic.
Sincerely hope this letter can bring you more hope. Frankly, Sir, with GFR being about 20ml/min, the condition is not that bad as you may imagin, and especially that the expectable recovery could be relatively much more satisying.
By the way, if that convenient for your replying me back with recent medical reports, like blood test report, urine test report and ultrasound test report. This is just a brief analysis on your condition, and I will have your condition further analyzed by my expert.
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