Initially, ADPKD has no symptoms, but it can be detected by ultrasound in
childhood. It progresses slowly over the years, and it attacks in youth or in
middle age in most cases. The symptoms, such as back pain, discomfort,
hematuria, urinary tract infections, are all associated with the influences of
the cysts. Chronic infection tends to co-exist with and aggravate the kidney
conditions. In the advanced stage, the kidneys become so large that they can be
felt by hands. Almost 33% of the kidney patients have kidney cysts in their
liver, which, however, does not affect the liver functions. Almost 50% of the
patients are found to have high blood pressure when diagnosed.
A small portion of the kidney patients with ADPKD develop cerebral aneurysm,
which would rupture among some patients, especially for those who can not
control their blood pressure well. 30% of the patients would have abnormal heart
valve by heart ultrasound examination. Although most patient with heart problems
can present on symptoms, the heart impairment can progress gradually.
In urinalysis, slight proteinuria and different degrees of hematuria can be
seen, but the red blood cyst casts are not common. Even if there is no
infections, pyuria often appears. With the cysts rupturing, overt gross
hematuria can be spotted.
Intravenous urinary angiography is very characteristic, which include
enlarged kidneys, irregular shape. Renal calices and renal pelvis would be
elongated with the pressure from the cysts.
Untreated, most patients would enter kidney failure around their 50s. Even
though patients with ADPKD have no symptoms, they should start treatment in the
early stage. Once patients develop many complications and symptoms, it would be
much harder for the treatment.
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