Polycystic Kidney Disease Flashcards

(29 cards)

1
Q

What type of condition is polycystic kidney disease?

A

Genetic condition

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2
Q

What is polycystic kidney disease characterised by?

A

The presence of cysts on both kidneys

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3
Q

What are the two forms of polycystic kidney disease?

A

Autosomal dominant
Autsomal recessive

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4
Q

How do the cysts affect the kidneys?

A

They cause the kidneys to enlarge and lose function over time

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5
Q

What is Autosomal dominant polycystic kidney disease the most common cause of?

A

Most common inherited cause of kidney disease

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6
Q

What is the prevalence of ADPKD?

A

1/1000

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7
Q

What are the 2 mutations associated with ADPKD?

A

PKD 1 on chromosome 16
PKD 2 gene on chromosome 4

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8
Q

What is the more common mutation that causes ADPKD?

A

PKD 1 mutation on chromosome 16

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9
Q

What are the main extra-renal manifestations of ADPKD?

A

Hepatic cysts
Cerebral aneurysm (subarachnoid)

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10
Q

How is ADPKD diagnosed?

A

Ultrasound
Genetic testing

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11
Q

What is the ultrasound diagnostic criteria for ADPKD in someone less than 30?

A

two cysts, unilateral or bilateral

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12
Q

What is the ultrasound diagnostic criteria for ADPKD in someone 30-59?

A

Two cysts in both kidneys

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13
Q

What is the ultrasound diagnostic criteria for ADPKD in someone older than 60?

A

Four cysts in both kidneys if aged > 60 years

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14
Q

What are the main features of ADPKD?

A

hypertension
recurrent UTIs
flank pain
haematuria
palpable kidneys
renal impairment
renal stones

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15
Q

When does end stage renal failure tend to occur in those with ADPKD?

A

At the mean age of 50

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16
Q

What type of cerebral aneurysm is common in those with ADPKD?

A

Berry aneurysm- which can result in a subarachnoid haemorrhage

17
Q

What is Autosomal recessive polycystic kidney disease caused by?

A

A mutation on chromosome 6

18
Q

What is the difference in severity of Autosomal recessive and autosomal dominant polycystic kidney disease?

A

Autosomal recessive is rarer and a lot more severe

19
Q

What does autosomal recessive PKD usually result in?

A

Non-viable pregnancy or death in early infancy

20
Q

How can autosomal recessive PKD result in a non-viable pregnancy or early death?

A

Due to oligohydramnios as the baby doesn’t produce enough urine

21
Q

What can oligohydramnios result in?

A

Underdevelopment of the lungs- respiratory failure

22
Q

How can a child with autosomal recessive PKD present?

A

With features of Potter’s syndrome secondary to oligohydramnios

23
Q

What occurs in all patients with autosomal recessive PKD?

A

Liver scarring

24
Q

What would a renal biopsy of autosomal recessive polycystic kidney disease show?

A

Multiple cylindrical lesions at right angles to the cortical surface

25
What is the first line management of ADPKD?
Tolvaptan
26
What is tolvaptan?
Vasopressin receptor 2 antagonist
27
How does Tolvaptan work?
Slows the progression of cyst development and renal insufficiency
28
What are the other forms of management for ADPKD?
Antihypertensives- hypertension Analgesia- renal colic related to stones or cysts. Antibiotics for infection. Drainage of infected cysts Dialysis for ESRF Renal transplant ESRF
29
What is used to screen for polycystic kidney disease?
Ultrasound