Will Polycystic Kidney Disease Develop Kidney Failure

Polycystic kidney disease is a chronic kidney disease and it takes relatively longer time to develop into end stage renal disease especially if patients have timely and effective treatments and home nursing measures, even though, the risk still exists.
When PKD develops into renal failure, it will have all the symptoms and complications of chronic kidney failure besides some special symptoms of renal cystic diseases like abdominal masses, fluid-filled sacs forming in kidneys.
The symptoms and complications when PKD develop into renal failure:
Water, electrolyte and acid-base metabolism disorders
Chronic renal failure, acid-base balance and electrolyte metabolism disorders are quite common. Electrolyte balance disorder is the most common type of metabolic disorders, metabolic acidosis and water.
(1) metabolic acidosis in patients with mild to moderate chronic renal failure (GFR> 25ml/min, or serum creatinine <350 μmol / l) in some patients due to renal tubular secretion of hydrogen ions obstacles or tubular HCO3-heavy absorption capacity decreased, thereby causing renal tubular acidosis. When GFR decreased to <25ml/min (serum creatinine> 350μmol / l), renal failure metabolites such as phosphoric acid, sulfuric acid and other acidic substances due to renal excretion obstacles retention can occur uremic acidosis. Mild chronic acidosis, the majority of patients with fewer symptoms, such as arterial HCO3-<15 mmol / L, you can appear obvious loss of appetite, vomiting, weakness, breathing deep.
(2) water-sodium metabolism, mainly Shuinazhuliu, or hypovolemic hyponatremia. Renal insufficiency, renal sodium load too much or excess capacity, the ability to adapt gradually decreased. Shuinazhuliu can be expressed varying degrees subcutaneous edema and / or body cavity effusion, which is quite common in clinical; prone to high blood pressure, left ventricular dysfunction (chest tightness, activity decreased resistance even at night not supine) and brain edema. The hypovolemic performance for low blood pressure and dehydration. Hyponatremia reasons, both cause (authenticity hyponatremia) due to a lack of sodium and too much water, or other factors caused by (False hyponatremia), while the latter is more common.
(3) potassium metabolism disorders: when the GFR reduced to 20-25ml/min or lower, renal potassium row capacity decreased, is prone to hyperkalemia; especially when excessive potassium intake, acidosis, infection, trauma, gastrointestinal bleeding occurs more hyperkalemia. There is a certain danger of serious hyperkalemia (serum potassium> 6.5mmol / l), the need for timely treatment to rescue. Sometimes inadequate potassium intake, gastrointestinal excessive loss of potassium-sparing diuretics and other factors, application row hypokalemia.
(4) calcium and phosphorus metabolism, mainly for of phosphorus too much and calcium deficiency. Calcium deficiency primarily with calcium intake, lack of active vitamin D, hyperphosphatemia, metabolic acidosis related to a variety of factors, the obvious lack of calcium, hypocalcemia can occur. "Phosphate regulating intestinal absorption and renal excretion of phosphorus. When the glomerular filtration rate, urinary discharge to reduce serum phosphate levels gradually increased. In the early stage of renal failure, serum calcium, phosphorus still remained in the normal range, and usually does not cause clinical symptoms appear only in late stage of renal failure (GFR <20ml/min) hyperphosphatemia, hypocalcemia hyperlipidemia. Hypocalcemia, hyperphosphatemia, active vitamin D deficiency can be induced by elevated parathyroid hormone (PTH), secondary hyperparathyroidism (referred to as hyperparathyroidism) and renal osteodystrophy.
(5) magnesium metabolism disorders: when GFR <20ml/min reduction in kidney platoon magnesium, often mild hypermagnesemia. Patients often no symptoms; such as the use of magnesium-containing drugs (antacids, laxatives, etc.), are more prone. Hypomagnesemia can occur even magnesium intake is insufficient or excessive application of diuretics.
Metabolic disorders of protein, carbohydrates, fats, and vitamins
The CRF protein metabolism in patients with general performance of the protein metabolite accumulation (azotemia), serum albumin levels, essential amino acids in plasma and tissues levels. Metabolic disorders with protein decomposition increased or / and reduce the synthesis of negative nitrogen balance, the renal excretion disorders and other factors related to.
Abnormal glucose metabolism mainly manifested as impaired glucose tolerance and hypoglycemia both cases, the former is more common, which is rare. Hyperlipidemia is quite common, and most of the patients showed mild to moderately high hypertriglyceridemia, a small number of patients showed mild hypercholesterolemia, or both. Vitamin fairly common metabolic disorders, such as increased serum levels of vitamin A, vitamin B6 and folic acid deficiency.
Cardiovascular system
Cardiovascular disease is one of the major complications of CKD patients and the most common cause of death. Especially into ESRD stage, the mortality rate is increased further (uremia cause of death in 45% -60%). Recent studies have found that uremic patients with adverse cardiovascular events and artery atherosclerotic cardiovascular disease about 15-20 times higher than the general population.
More common cardiovascular disease, hypertension and left ventricular hypertrophy, heart failure, uremic cardiomyopathy, pericardial effusion, pericarditis, vascular calcification and arterial atherosclerosis, etc.. In recent years, found that hyperphosphatemia, calcium abnormal distribution and vascular protective proteins (such as fetuin-A) caused by a lack of vascular calcification, also plays an important role in cardiovascular disease.
Respiratory symptoms
Fluid overload or acidosis can be shortness of breath, shortness of breath, severe acidosis can cause breathing deep. Fluid overload, heart failure can cause pulmonary edema or pleural effusion. Alveolar capillary permeability induced by uremic toxins can cause lung congestion uremic pulmonary edema, chest x-ray examination at this time, there may be a "butterfly-wing" levy, timely diuresis or dialysis of the above symptoms can rapidly improve.
Gastrointestinal symptoms
Mainly loss of appetite, nausea, vomiting, oral Niaowei. Gastrointestinal bleeding are more common, and its incidence is significantly higher than normal, mostly due to the gastric mucosal erosions or peptic ulcer, especially in the former is the most common.
Blood system performance
CRF patients with abnormal blood system mainly for renal anemia and bleeding tendency. Most patients generally have light, moderate anemia, the reason is mainly due to erythropoietin lack, it is known as renal anemia; such as accompanied by iron deficiency, malnutrition, bleeding, and other factors that may aggravate the degree of anemia. Late CRF patients with bleeding tendency, such as subcutaneous or mucous membrane bleeding, petechiae, gastrointestinal bleeding, cerebrovascular bleeding.
Neuromuscular symptoms
Early symptoms may have insomnia, difficulty concentrating, memory loss. Uremia indifferent response, delirium, convulsions, hallucinations, coma, and mental disorders. Peripheral neuropathy is very common, more significant sensory nerve disorder, the most common is the loss of sensation in extremities sock-like distribution, can also be numbness, burning sensation or pain, deep reflection slow or disappear, and may have neuromuscular increased excitability, such as muscle tremors, spasms, restless legs syndrome. The initial dialysis patients dialysis disequilibrium syndrome may occur, appear as nausea, vomiting, headache, convulsions, mainly due to the intracellular and extracellular fluid osmotic imbalances and brain edema after hemodialysis, caused by increased intracranial pressure.
Endocrine dysfunction
Mainly: (1) kidney itself endocrine dysfunction: 1,25 (OH) 2 vitamin D3, erythrocyte erythropoietin and intrarenal renin angiotensin tangled II too much; ② hypothalamic-pituitary endocrine dysfunction: such as lactation hormone, melanocyte hormone (MSH), luteinizing hormone (FSH), follicle-stimulating hormone (LH), promoting increased levels of the adrenal cortex hormone (ACTH): ⑧ outside weeks of endocrine disorders: Most patients had serum PTH liter high, some patients (about a quarter) a mild lower thyroid hormone levels; well as insulin receptor disorder, hypogonadism.
Bone lesions
Renal osteodystrophy (renal osteodystrophy) is fairly common, including fibrocystic osteitis (high-turnover bone disease), poor bone formation (adynamic bone disease) and osteomalacia (low-turnover bone disease) and bone quality osteoporosis. Approximately 35% of the abnormal bone X-ray found in pre-dialysis patients, but bone pain, difficulties in walking and spontaneous fractures are quite rare (less than 10%). Abnormal bone biopsy (bone biopsy) of approximately 90%, early diagnosis is to rely on bone biopsy.
Fibrocystic osteitis is mainly caused by excessive PTH prone bone salt dissolves, rib fractures. X-ray examination showed bone cystic defects (such as the phalanx, ribs) and osteoporosis (such as the spine, pelvis, femur, etc.) performance.
Adverse occurrence of bone formation, serum PTH concentration is relatively low, some osteogenic factors related to insufficient and therefore not sufficient to maintain bone regeneration; dialysis patients, such as long-term excessive application of the active form of vitamin D, calcium, and other drugs or dialysate calcium content High, you can make relatively low concentrations of serum PTH.