Polycystic kidney disease
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Polycystic kidney disease
Renal
Renal
Renal system anatomy and physiology
Hydration
Body fluid compartments
Movement of water between body compartments
Renal clearance
Glomerular filtration
TF/Px ratio and TF/Pinulin
Measuring renal plasma flow and renal blood flow
Regulation of renal blood flow
Tubular reabsorption and secretion
Tubular secretion of PAH
Tubular reabsorption of glucose
Urea recycling
Tubular reabsorption and secretion of weak acids and bases
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Renin-angiotensin-aldosterone system
Sodium homeostasis
Potassium homeostasis
Phosphate, calcium and magnesium homeostasis
Osmoregulation
Antidiuretic hormone
Kidney countercurrent multiplication
Free water clearance
Vitamin D
Erythropoietin
Physiologic pH and buffers
Buffering and Henderson-Hasselbalch equation
The role of the kidney in acid-base balance
Acid-base map and compensatory mechanisms
Respiratory acidosis
Metabolic acidosis
Plasma anion gap
Respiratory alkalosis
Metabolic alkalosis
Renal agenesis
Horseshoe kidney
Potter sequence
Hyperphosphatemia
Hypophosphatemia
Hypernatremia
Hyponatremia
Hypermagnesemia
Hypomagnesemia
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypocalcemia
Renal tubular acidosis
Minimal change disease
Diabetic nephropathy
Focal segmental glomerulosclerosis (NORD)
Amyloidosis
Membranous nephropathy
Lupus nephritis
Membranoproliferative glomerulonephritis
Poststreptococcal glomerulonephritis
Rapidly progressive glomerulonephritis
IgA nephropathy (NORD)
Alport syndrome
Kidney stones
Hydronephrosis
Acute pyelonephritis
Chronic pyelonephritis
Prerenal azotemia
Renal azotemia
Acute tubular necrosis
Postrenal azotemia
Renal papillary necrosis
Renal cortical necrosis
Chronic kidney disease
Polycystic kidney disease
Multicystic dysplastic kidney
Medullary cystic kidney disease
Medullary sponge kidney
Renal artery stenosis
Renal cell carcinoma
Angiomyolipoma
Nephroblastoma (Wilms tumor)
WAGR syndrome
Beckwith-Wiedemann syndrome
Posterior urethral valves
Hypospadias and epispadias
Vesicoureteral reflux
Bladder exstrophy
Urinary incontinence
Neurogenic bladder
Lower urinary tract infection
Transitional cell carcinoma
Non-urothelial bladder cancers
Odds ratio
Sensitivity and specificity
Positive and negative predictive value
Hypertension
Osmotic diuretics
Potassium sparing diuretics
Loop diuretics
Thiazide and thiazide-like diuretics
Carbonic anhydrase inhibitors
ACE inhibitors, ARBs and direct renin inhibitors
Non-corticosteroid immunosuppressants and immunotherapies
Transplant rejection
Assessments
Polycystic kidney disease
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Polycystic kidney disease
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USMLE® Step 1 style questions USMLE
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Retrieved from: Wikimedia Commons
This patient’s condition follows which of the following inheritance patterns?
Memory Anchors and Partner Content
External References
First Aid
2016
PKD genes
polycystic kidney disease and p. 71
External Links
Transcript
Content Reviewers
Rishi Desai, MD, MPHContributors
Tanner Marshall, MS
Polycystic kidney disease, or PKD, is a genetic disease in which the kidneys become filled with hundreds of cysts, or fluid-filled sacs, causing them to be larger than normal and to quit functioning over time.
These cysts develop in the outer layer—the cortex, as well as the inner layer—the medulla—of both kidneys.
These cysts, which are lined with renal tubular epithelium, fill up with fluid and get larger and larger over time, making the kidneys much larger than normal.
The blood vessels that feed neighboring healthy nephrons can get compressed by growing cysts, which literally starves them of oxygen.
Poorly perfused kidneys respond by activating the renin-angiotensin-aldosterone system, which facilitates fluid retention and leads to hypertension.
Also, expanding cysts can compress the collecting system, causing urinary stasis, and in some cases this can lead to kidney stones.
Additionally, destruction of the normal renal architecture can cause symptoms like flank pain and hematuria, or blood in the urine.
Over time, as enough nephrons are affected, it leads to renal insufficiency and eventually renal failure.
Now the first type of PKD is autosomal dominant PKD or ADPKD, which used to be called adult PKD, since symptoms usually manifest in adulthood.
The first gene responsible for ADPKD is PKD1, which when mutated causes the more severe and earlier onset variety, and PKD2, which when mutated causes less severe disease and is also later in onset. PKD1 and PKD2 code for the polycystin 1 and polycystin 2 proteins, respectively, which are components of the primary cilium.
Now, the primary cilium is an appendage that sticks out from most cells in the body and receives developmentally important signals.
More specifically, in the nephron, as the urinary filtrate flows by and cause it to bend, polycystin 1 and polycystin 2 respond by allowing calcium influx, which activates pathways in the cell that inhibit cell proliferation.
Summary
Polycystic kidney disease or PKD, is a genetic disorder in which the kidneys become filled with hundreds of cysts, causing them to be larger than normal and to fail over time. PKD presents with high blood pressure, headaches, abdominal pain, blood in the urine, and excessive urination. Other symptoms include pain in the back, and cyst formation (renal and other organs). PKD comes in two varieties: autosomal dominant, which presents in adulthood, and autosomal recessive, which presents in infancy or even before birth. Treatment of PKD typically involves medications to control symptoms, lifestyle changes, and in some cases, surgery.
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