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Polycystic Kidney Disease final.pptx

28 Mar 2023
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Polycystic Kidney Disease final.pptx

  1. Polycystic Kidney Disease Done by: Mays Khaled Najjar Supervised by: Dr. Sameer Zawahreh Date: 3/22/2023 3/22/2023 1
  2. OUTLINES Definition Symptoms Autosomal Dominant Polycystic Kidney Disease Autosomal Recessive Polycystic Kidney Disease Reference 3/22/2023 2
  3. 3/22/2023 3 Cystic Kidney Diseases: Renal Cysts Inherited Enlarged Kidneys with cysts in medulla and cortex. PKD Shrunk kidneys with cysts in the medulla Medullary Cystic Kidney. Non-Inherited Multi-Cystic Dysplastic Kidney.
  4. Definition Polycystic kidney disease (PKD) is an inherited disorder characterized by the development of multiple cysts develop primarily within kidneys, causing kidneys to enlarge and lose function over time. 3/22/2023 4
  5. Symptoms 3/22/2023 5 Hematuria 01 Flank Pain 02 Hypertension 03 Palpable Kidneys on examination 04
  6. 3/22/2023 6 PKD Types Autosomal Dominant Polycystic Kidney Disease Autosomal Recessive Polycystic Kidney Disease
  7. Autosomal Dominant PKD (ADPKD) 3/22/2023 7 PKD 1 (85 % of cases, on chromosome 16) or PKD2 (15% of cases, on chromosome 4) genes mutations. Its dominant on personal level but recessive on cellular level. Could form anywhere of the nephron, but less than 5% of nephrons are affected. Microscopic cysts at birth and progressively enlarge over the 3rd or 4th decade. Enlarge cysts compress renal parenchyma and lead to fibrosis. Called Adult PKD, and it’s the most common genetic cause of renal failure.
  8. Associated features and complications 3/22/2023 8 Nephrolithiasis and UTI Infection or hemorrhage into the cyst. Intracerebral berry syndrome Other organ cysts (Liver, pancreas, colon, spleen, seminal vesicles and aortic root). Abdominal and inguinal hernias.
  9. Diagnosis 3/22/2023 9 Ultrasound is the confirmatory CT scan and MRI are alternatives
  10. Treatment 3/22/2023 10 No curative treatment. Drain cysts if symptomatic. Treat infections with antibiotics. Treat HTN with ACEi or ARBs. For Kidney failure, dialysis or kidney transplant.
  11. Autosomal Recessive PKD (ARPKD) 3/22/2023 11 PKHD1 gene mutation, which codes for fibrocystin proteins in kidneys and bile ducts. Occurs in fetal period and causes oligohydramnios and Potter sequence. Pulmonary hypoplasia is the most common cause of death in neonatal life in ARPKD patient. Associated with congenital liver fibrosis that could lead to portal HTN and its complications. Associated with dilated bile ducts ( lead to cholestasis if in hepatic bile ducts, and ascending cholangitis in CBD)
  12. Potter Sequence 3/22/2023 12
  13. Diagnosis 3/22/2023 13 Prenatal ultrasound shows bilateral enlarged kidneys with cysts, hepatomegaly, dilated bile ducts and oligohydramnios. Molecular genetics if the diagnosis is not clear.
  14. Treatment 3/22/2023 14 No curative treatment. Manage respiratory issues in newborns. For ESRD, dialysis or kidney transplant.
  15. Reference • Agabegi, S. S., Agabegi, E. D., Duncan, M. D., & Chuang, K. (2019). Step-up to medicine. Wolters Kluwer Health. 3/22/2023 15
  16. Thank you 3/22/2023 16
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