Treating autosomal dominant polycystic kidney disease
Although there are some potentially useful medications that can reduce the growth rate of cysts, there is currently no treatment that can cure autosomal dominant polycystic kidney disease (ADPKD) or stop cysts forming in the kidneys.
However, treatment is available to help manage the various problems the condition can cause, such as high blood pressure (hypertension), pain and kidney stones.
If you are diagnosed with ADPKD, you will usually see a kidney specialist, who can help draw up a suitable treatment plan.
This plan will also include what you would want to do if your kidneys stopped working sufficiently (known as kidney failure).
Some of the main treatments are described below.
High blood pressure
High blood pressure in people with ADPKD is usually treated with medication. The two medications most widely used are angiotensin-converting enzyme (ACE) inhibitors and angiotensin-2 receptor blockers (ARBs).
There are also some lifestyle changes you can make to help reduce your blood pressure, such as cutting your salt intake to less than 6g (0.2oz) a day. 6g of salt is about one teaspoonful.
Read more about treating high blood pressure.
In many cases of ADPKD, any pain you experience can be relieved by treating the underlying cause, such as kidney stones or a urinary tract infection (UTI).
If you need to take a painkiller, paracetamol is the best medication to try first. If your pain is particularly severe, you may be prescribed a stronger painkiller, such as codeine or tramadol.
Your doctor will usually recommend avoiding a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, because they could disrupt kidney function and interfere with medications prescribed to control your blood pressure. However, a short course of NSAIDs may sometimes be safe for people with well controlled blood pressure and relatively normal kidney function.
If you have long-term (chronic) pain, you may be prescribed antidepressants or anticonvulsant medications (which are normally used to treat epilepsy), as these can also relieve some types of pain.
Occasionally, draining large cysts can be performed to relieve the pain caused by the increased pressure.
Small kidney stones pass out of your body when you urinate. If needed, you may be given a strong painkiller and medication to stop you feeling sick or vomiting. Making sure you drink plenty of water, which will increase the flow of urine, can also help by flushing the stone into the bladder.
If a kidney stone is too big to be passed naturally, you may need to have treatment to remove it. Possible treatment options include:
- using energy waves to break the stone into smaller pieces – this is known as extracorporeal shock wave lithotripsy (ESWL)
- passing a thin telescopic instrument called a ureteroscope up your urethra (the tube that carries urine out of body) to remove or break up the stone
Read more about treating kidney stones.
Urinary tract infections (UTIs)
UTIs can often be treated with a course of antibiotic tablets lasting 7-14 days.
Drink plenty of fluids while you are waiting for the antibiotics to take effect, as this will help relieve symptoms of a high temperature. Paracetamol can be used to relieve pain.
It's important to see your doctor as soon as possible if you develop symptoms of a UTI, as it could spread to the cysts in your kidneys if left untreated.
Infection in the cysts is harder to cure, because it can be difficult for the antibiotics to penetrate them. If the infection persists despite antibiotic treatment, the infected cysts may need to be drained during surgery or with a needle inserted through your skin.
In severe, persistent or frequently recurring cases, having surgery to remove one or both of your kidneys – followed by dialysis or a kidney transplant (see below) – may be recommended.
You will have blood tests at varying intervals to check your kidney function. You should discuss with your doctors how you would like to be treated if your condition reaches a stage where your kidneys stop working altogether (kidney failure).
The two main treatment options for kidney failure are:
- dialysis – where a machine replicates some of your kidneys' functions
- kidney transplant – where a kidney is removed from a donor and implanted into a patient
A kidney donor can be somebody who is recently deceased or, as is increasingly common, someone who is still alive and wants to donate one of their healthy kidneys.
A person only needs one kidney to survive. Therefore, unlike other types of organ donation, a living person can donate a kidney. Close relatives usually make the best match, so you may want to ask your relatives if they would consider having themselves tested to see if they are a suitable donor.
A few people with kidney failure decide against having either dialysis or kidney transplants, preferring simple treatment of their symptoms. They may, for example, choose this option if it is unlikely that dialysis will significantly prolong their life or improve its quality. If this choice is made, supportive treatment to help control symptoms is provided to make the end of life as comfortable as possible.
If you have ADPKD, your kidneys will be more vulnerable to injury. For example, a sudden knock or blow to your kidneys could cause the cysts to split and bleed, leading to severe and intense pain.
Therefore, it is usually recommended that you avoid all types of contact sport, such as rugby and football.
Page last reviewed: 09/06/2014
Next review due: 09/06/2016