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Z Year3 Urology > Polycystic Kidney Disease > Flashcards

Polycystic Kidney Disease Flashcards

1
Q

What is Polycystic Kidney Disease (PKD)?

A
  • Congenital
  • Hundreds of fluid-filled sacks
  • Progressive enlargement & loss of function
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2
Q

What do the cysts do?

A

compress neighbouring structures

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3
Q

What does compression of the blood vessels lead to?

A

Hypoperfusion leads to Activation of renin-angiotensin system leads to HTN

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4
Q

What does compression of the collecting ducts lead to?

A

urine stasis leads to kidney stones

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5
Q

What are two types of PKD?

A
  • austosomal dominant

- autosomal recessive

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6
Q

What is autosomal dominant PCKD?

A
  1. aka. Adult PKD
  2. PKD1 or PKD2 gene mutations
  3. FH needed for diagnosis
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7
Q

What is AD PCKD associated with?

A
  1. Cerebral artery berry aneurysms & SAH⚠️
  2. Mitral valve prolapse
  3. Benign hepatic cysts
  4. Heart failure
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8
Q

What is autosomal recessive PCKD?

A
  1. aka. Child PKD

2. PKHD1 gene

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9
Q

What is autosomal recessive PKD associated with?

A
  1. Oligohydraminos
  2. Congenital hepatic fibrosis leads to Portal HTN
  3. Ascending cholangitis
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10
Q

What types of PCKD is more common?

A

autosomal dominant

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11
Q

What is the presentation of PCKD?

A
  1. Hypertension
  2. Flank pain
  3. Haematuria
  4. Palpable kidneys
  5. Headache
  6. SAH (can be first presentation esp in young)
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12
Q

What bloods are done for PCKD?

A

U&Es, lipid profile

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13
Q

What bedside tests are done of PCKD?

A
  1. Urinalysis
  2. Urine culture
  3. BP measurement
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14
Q

What imaging is done for PCKD?

A
  • Renal USS (non-invasive)
  • Abdo CT or MRI
  • Prenatal renal USS
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15
Q

What should be done with Fhx of ADPKD?

A

earlier HTN screening

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16
Q

How many cysts are needed for disease confirmation?

A
  1. 15 to 39 years of age - at least 3 (unilateral or bilateral) renal cysts
  2. 40 to 59 years of age - at least 2 cysts in each kidney
  3. > 60 years of age - at least 4 cysts in each kidney
17
Q

What is the conservative management of PKD?

A

Healthy (reno-protective) lifestyle choices

18
Q

What is the medical management of PCKD if radpidly progressing?

19
Q

What is the medical management of HTN in PCKD?

A

ARB or ACEi

20
Q

What is the interventional management of PCKD?

A
  1. Cyst aspiration (under CT guidance)
  2. Unilateral/ bilateral nephrectomy
  3. Renal transplant

Z Year3 Urology (18 decks)

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