Medical expert of the article
New publications
Treatment of polycystic kidney disease
Last reviewed: 04.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Patients with polycystic kidney disease require long-term treatment with periodically repeated courses of drug therapy and constant adherence to a dietary regimen. Treatment of polycystic kidney disease is aimed at eliminating or weakening pyelonephritis, improving and maintaining kidney function.
Drug treatment of polycystic kidney disease
Antibacterial treatment of polycystic kidney disease is indicated, since this developmental defect is almost always accompanied by the infection pyelonephritis.
The choice of antibiotic and chemotherapeutic drug depends primarily on the results of determining the sensitivity of the isolated microorganism strains to them. Nephrotoxicity of drugs and the risk of their accumulation in the body should be especially taken into account. Treatment should be long-term; its effectiveness can be judged only when two urine culture tests have given a negative result, renal function tests have improved, and blood counts and ESR have returned to normal.
Hypertensive drugs are prescribed according to the usual scheme. In the treatment of hypertension, one should strive to increase the excretion of salts in the urine or reduce the intake of sodium into the body.
Polycystic kidney disease: surgical treatment
Indications for surgical treatment of polycystic kidney disease are individual; as a rule, they are strictly regulated and aimed at eliminating complications. All types of operations for polycystic kidney disease are palliative. Surgical treatment of polycystic kidney disease is performed in cases of severe pain that complicates the daily life of patients, in cases of suppuration of cysts, in cases of total life-threatening hematuria, in cases of hypertension that is not amenable to hypotensive therapy, in cases of large cysts that compress the main vessels of the kidney and pulmonary artery, in cases of malignant degeneration of the cystic kidney, in cases of large stones in the pelvis or occluding in the ureter.
The most common operation for polycystic kidney disease remains surgical decompression, proposed in 1911 by Rovsing; this method was called ignipuncture. Indications for it should be based on age, nature of the disease, severity of complications and effectiveness of conservative therapy. Ignipuncture allows achieving a long-term positive effect if it is performed in the compensation stage in patients aged 30-50 years. Surgical decompression reduces the size of cysts, relieves pain, reduces intrarenal pressure, improves microcirculation in the kidney and nephron function. A supporter of this operation was SP Fedorov (1923), he was the first to propose and perform after cyst puncture wrapping the kidney with the greater omentum (omentonephropexy), which was later used by M.D. Javad-Zade, but there was no restoration of kidney function.
In 1961, a simpler and safer treatment for polycystic kidney disease was developed and introduced into clinical practice - percutaneous cyst puncture. Puncture of the maximum possible number of cysts in polycystic kidney disease allows one to obtain a result close to the result achieved by ignipuncture without the severe trauma caused by surgical intervention.
With percutaneous puncture performed under ultrasound or CT control, the risk of extensive trauma to the renal tissue is very low, even during decompression of cysts located deep in the renal parenchyma. Percutaneous puncture performed once every 4-6 months allows for long-term maintenance of the main metabolic functions of the kidneys in patients with polycystic disease in a state of compensation. Permanently performed percutaneous puncture of polycystic kidney cysts can be considered an alternative to open surgical treatment.
A.V. Lyulko recommends transferring patients with high azotemia and creatininemia to program dialysis with subsequent kidney transplantation. Including a patient in program dialysis practically does not provide stable remission, and patients either remain on hemodialysis for life or need kidney transplantation.
Combination of polycystic kidney disease with other kidney abnormalities
The literature describes cases of frequent combination of polycystic kidney disease with polycystic liver disease, pancreas disease and other organs. It can also be combined with other anomalies of the kidneys themselves. In this case, both congenital and acquired cysts of a retention nature are detected.
As a special rare case, polycystic horseshoe kidney with retention cysts in the isthmus was observed.
Diet for polycystic kidney disease
Adequate nutrition in terms of quantity and quality is necessary. In case of inadequate nutrition, especially in case of insufficient protein content in food, the disease is more severe. The daily requirement for protein (90-100 g) is best satisfied by introducing additional protein products (cottage cheese, skim milk) into the diet. The amount of fats and carbohydrates should be limited. A diet with sodium restriction is effective (maximum daily consumption of table salt is 3-4 g). The daily energy value should be at least 3000 kcal. The main part of energy expenditure should be replenished by carbohydrates and vegetable fats; vitamin intake is mandatory.
[