Diagnose Of Polycystic Kidney Disease

How to diagnose Polycystic Kidney Disease (PKD)? PKD is a genetic kidney disorder; usually, the diagnosis of this disease should be based on family history, clinical symptoms, physical tests and other auxiliary examinations:
1. Family history:
Generally, if one of the parents have the disease, incidence rate of PKD is 50 percent in children; if both parents have this disease, the morbidity can increase to 75 percent.
2. Clinical symptoms:
1) Urinary system symptoms: the onset of PKD is usually over 40 years old. Patients often present obvious symptoms such as back or abdominal pains, renal colic, hematuria, headaches, nausea, vomiting and weight loss.
2) Cardiovascular symptoms
Patients often suffer from high blood pressure, mitral valve prolapse, left ventricular hypertrophy and aortic insufficiency.
3) Digestive system symptoms, including combined liver cysts, pancreas cysts and spleen cysts.
3. Imaging tests
1) Ultrasound: manifestations of PKD in ultrasound mainly include obviously augmented kidney size, various cysts and intensified echo in renal parenchyma. High acuity can detect small cysts with 0.2 cm in diameter, thereby, ultrasound is often applied as a antenatal diagnosis and family member screening method of PKD.
As is put forward by Ravine in 1994, diagnosis standard for PKD through B-ultrasound is: for those with family history and less than 30 years old, there exist two cysts in bilateral or unilateral kidneys; at least 2 cysts in bilateral kidneys for 30-59 year old patients; at least 4 cysts for those over 60 years old.
In those with no family history, PKD can be diagnosed if there are more than 10 cysts in the kidneys.
2) CT and MRI: the two tests can find out 0.3-0.5cm kidney cysts. MRI can test out kidney size; the ratio between kidney cysts and normal renal tissue sectional area can reflect PKD progression condition sensitively.
3) Gene diagnosis: gene test techniques mainly include gene linkage analysis, microsatellite DNA detection and direct detection of gene mutation, which are often take as antenatal diagnosis or performed in those without familial inheritance.
4. Auxiliary examinations:
1) Urinalysis: there are no abnormal symptoms at early stage; in developing processes, many patients experience hematuria. Proteinuria can be seen in some patients.
2) Urine osmolality: for PKD patients, damage of kidney concentration function comes earlier than decreased Glomerular Filtration Rate(GFR). Urine oamolality is an sensitive indicator for impaired urine concentration.
3) KUB plain film: it can reflect irregular shape of the kidneys and increased kidney developing.
The above is mainly related to the diagnosis of PKD. For those with family history, it is advised to develop healthy renal habits so as not to stimulate growth of the cysts. Cysts over 5 cm in diameter are likely to result in kidney damage, thereby, positive treatment is suggested.
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