Author: Care Online
Image: shutterstock (illustration not party involved)
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Dr. Liu Yuzhi: Hello everyone, I am Dr. Liu Yuzhi and welcome Dr. Wu Yiwen to the care line.
Dr. Wu Yiwen: Hello everyone, I am Dr. Wu Yiwen.
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Dr. Liu Yuzhi: What is the cause of polycystic kidney disease?
Dr. Wu Yiwen: Polycystic kidney is commonly known as bubble kidney, which is inside the kidney. You can see a model like this. In the normal tissue, it has a lot of blisters and vacuoles, which erode our normal tissue. So far, this It is a genetic disease. It is a dominant inheritance. There are two main genetic defects, including the PKD1 gene and the PKD2 gene. Because this is a dominant inheritance, as long as one of the parents gets the disease, each person will get the disease. A child has a 50% chance of getting this disease. It is very important clinically. When the patient is being consulted, he should pay attention to his family history, not only in the immediate first generation, but even in the later generations. A generation of relatives to take a look at some of their genetic tendencies.
Dr. Liu Yuzhi: What are the common symptoms of polycystic kidney disease?
Dr. Wu Yiwen: There are two symptoms of polycystic kidney disease. The first one is in the kidney itself. Because there are so many vacuoles, it causes tissue changes in the entire kidney and the symptoms are caused by the enlargement of the shape of the kidney. These include kidney degeneration. When you are older, you may suffer from abdominal pain, hematuria, kidney infection, or changes in blood pressure. In addition, because of this gene mutation, it will affect many other organs throughout the body, so there will also be many polycystic kidney disease patients. Some symptoms other than the kidneys include cysts of various sizes in the liver, diverticula or inflammation in our intestines, and some cysts in the blood vessels of our brain. Hemangioma, all glands in other parts, including our pancreas, or our other glands, and even the valves of the heart, will also have abnormalities. When we meet a patient with polycystic kidney disease, not only us We will pay attention to his kidney diseases, and we will also look at the systemic conditions caused by these genetic defects.
Dr. Liu Yuzhi: Which groups are at high risk for polycystic kidney disease?
Dr. Wu Yiwen: For patients with poor renal function, or patients with waist pain or the five major symptoms, we will especially check if they have any family history. If we talk about family history, we have seen that they have some Inherited diseases, and even a family history of dialysis, are all high-risk groups for polycystic kidney disease.
Dr. Liu Yuzhi: What health impacts will polycystic kidney disease bring?
Dr. Wu Yiwen: Polycystic kidney disease is an invisible killer. It will slowly destroy our normal tissues in terms of structure, thus causing the kidney function to slowly decline. When the kidney function declines, the glomerular filtration rate is less than 15 points, that is, when the fifth stage of kidney function is poor, the patient will face the risk of needing dialysis, which is commonly known as kidney dialysis. So far, we have two types of polycystic kidney disease, namely type 1 and type 2 polycystic kidney disease. Cystic kidney disease, the first type of polycystic kidney disease, worsens relatively quickly, so we can see many patients who may develop the disease in their 30s or 40s, 10 or 15 years later. , when you are 50 or 60 years old, you will enter the state of dialysis. In addition, in the case of polycystic kidney disease, because it is a dominant inheritance, it is often included in our genetic consultation and marriage. Fertility consultation with the next generation will also bring a lot of psychological pressure to the patient. This part also requires team care to strengthen health education and counseling.
Dr. Liu Yuzhi: What are the common reactions of patients when polycystic kidney disease is diagnosed?
Dr. Wu Yiwen: Many patients will be a little angry at first, or give up on themselves. After our many rounds of education and treatment, they are very willing to face some kidney problems and receive education and treatment. , throughout the course of the disease, cross-disciplinary companionship is not only provided by doctors, health teachers, but also by some social workers or volunteer partners, which is very important to the patient.
Dr. Liu Yuzhi: What were the treatments for polycystic kidney disease in the past?
Dr. Wu Yiwen: Most of them are traditional conservative treatments. In addition to some blood pressure and risk factor control of chronic kidney disease, we will ask him to make some dietary adjustments, including the intake of salt, sugar and fatty foods. At the same time, we Some drugs will also be used to allow him to achieve relatively normal blood pressure and blood sugar control. When these factors are poorly controlled, the patient may eventually be at risk of dialysis.
Dr. Liu Yuzhi: How can new oral drugs help polycystic kidney disease?
Dr. Wu Yiwen: In recent years, due to the development and progress of drugs, there have been some breakthrough treatments for polycystic kidney disease. New oral polycystic kidney drugs can accurately inhibit the occurrence and number of blisters in our kidneys. , it will also inhibit the secretion of water in our blisters, improve the overall kidney function, and delay the increase in the number of kidney blisters. Currently, this drug can also be applied for through the payment method of special health insurance. In fact, it is a very revolutionary Sexual and breakthrough therapies. Judging from my own experience in treating patients, I have a kidney dialysis patient here. This old man started dialysis because of polycystic kidney disease. Among his five children, three daughters Suffering from polycystic kidney disease, two of them have started dialysis. Since this new drug began to be introduced, we have told the old gentleman’s children that everyone should come for screening, and we have been very successful. For a patient whose kidney function has not yet reached the end stage, a project was started to introduce precise oral drug treatment for polycystic kidney disease. This patient was a very young female patient. After such treatment, his kidney function has improved over the years. , can be maintained very stable, so whether it is some cross-field treatments or prescriptions from doctors, it can give patients more confidence that this disease can be treated more ideally.
Dr. Liu Yuzhi: Thank you Dr. Wu for coming to the care line. See you next time. Goodbye.
Dr. Wu Yiwen: Goodbye.
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(This article is reprinted with permission from “Care Online”, the original text is published here)
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2024-02-17 09:05:56
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