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Treatment of polycystic kidney disease
Last reviewed: 23.04.2024
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Patients with polycystic kidneys need long-term treatment with the appointment of periodically repeated courses of drug therapy and in constant compliance with the diet regime. Treatment of polycystic kidney is aimed at the elimination or weakening of pyelonephritis, the improvement and preservation of kidney function.
Medicamentous treatment of polycystic kidney disease
Antibacterial treatment of polycystic kidney is shown, since this malformation is almost always accompanied by pyelonephritis infection.
The choice of an antibiotic and a chemotherapeutic drug depends primarily on the result of determining the sensitivity of the isolated strains of microorganisms to them. It should be especially taken into account the nephrotoxicity of the preparations and the danger of their cumulation in the body. Treatment should be lengthy; its effectiveness can be judged only when two culture tests of urine produced a negative result, functional tests of the kidneys were improved, blood and ESR parameters were normalized.
Hypertensive agents are prescribed according to the usual scheme. In the treatment of hypertension should strive to increase the release of salts with urine or reduce the intake of sodium in the body.
Polycystic kidney: surgical treatment
Indications for operative treatment of polycystic kidney are individual; as a rule, they are strictly regulated and aimed at eliminating complications. All types of operations with polycystic palliative. Operative treatment of polycystic kidney is performed with severe pain complicating the ordinary life of patients, with suppuration of cysts, with total life threatening hematuria, with hypertension, not amenable to hypotensive therapy, with large cysts compressing the major vessels of the kidney and LMS, with malignant degenerations of the cystic kidney, with large stones in the pelvis or occlusive in the ureter.
The most common operation with polycystic kidney remains operative decompression, proposed in 1911 by Rowwing; this method is called igunipuncture. Indications for it should be based on age, the nature of the disease, the severity of complications and the effectiveness of conservative therapy. Iglinpunktura allows to achieve a long-term positive effect if it is performed in the stage of compensation in patients aged 30-50 years. Operative decompression reduces the size of cysts, relieves pain, reduces intrarenal pressure, improves microcirculation in the kidney and the function of nephrons. The supporter of this operation was a joint venture. Fyodorov (1923), he first proposed and performed after the puncture of the cysts enveloping the kidney with a large omentum (omentonephrospexia), which later applied MD. Javad-Zade, however, recovery of kidney function did not occur.
In 1961, a simpler and safer treatment of polycystic kidneys was developed and introduced into clinical practice - percutaneous puncture of the cysts. The puncture of the maximum possible number of cysts in polycystic kidneys allows to obtain a result close to the result achieved by a needlepunk without a serious trauma caused by an operation.
When a percutaneous puncture is performed under the control of ultrasound or CT scan, the risk of extensive trauma to the kidney tissue is very low even with decompression of the cysts located deep in the renal parenchyma. Percutaneous puncture, performed once every 4-6 months, allows long-term maintenance of the basic metabolic functions of the kidneys in patients with polycystosis in a state of compensation. Permanent percutaneous puncture of cysts of polycystic kidney can be considered an alternative to open surgical treatment.
A.V. Lulko recommends that patients with high rates of azotemia and creatinineemia be transferred to program dialysis with subsequent kidney transplantation. Inclusion of a patient in program dialysis practically does not provide a stable remission, and patients either remain for life on hemodialysis, or require kidney transplantation.
The combination of polycystic diseases with other kidney anomalies
In the literature, cases of frequent combination of polycystic kidney with polycystic liver, pancreas and other organs are described. It can be combined with other anomalies of the kidneys themselves. In this case, both congenital and acquired, retentive character cysts are detected.
As a special rare case, polycystosis of the horseshoe kidney with retention cysts in the isthmus was observed.
Diet for polycystic kidney disease
It is necessary to eat adequately in a quantitative and qualitative way. With malnutrition, especially with insufficient protein in food, the disease is more severe. The daily requirement for protein (90-100 g) is best satisfied by the introduction of additional protein products into the diet (cottage cheese, skim milk). The amount of fats and carbohydrates should be limited. Effective diet with sodium restriction (maximum consumption of table salt per day 3-4 g). The daily energy value should be at least 3000 kcal. The main part of energy costs should be replenished with carbohydrates and vegetable fats; must take vitamins.
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