Only one parent needs to have the disease in order

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kidney disease, but children can develop the disorder. Only one parent needs to have the disease in order for it to pass along to the children. If one parent has ADPKD, each child has a 50 percent chance of getting the disease. Thisform accounts for about 90 percent of cases of polycystic kidney disease. Polycystic liver disease is the most common expression of the disease outside the kidney. Nearly 75% of those with ADPKD will develop cystic livers by their seventh decade. Nearly 8% will develop cranial aneurysms. Cysts may develop in other organs systems, such as the pancreas, arachnoid membrane, spleen, ovaries, testicles, or seminal vesselsAutosomal recessive polycystic kidney disease (ARPKD).This type is far less common than is ADPKD. The signs and symptoms often appear shortly after birth. Sometimes, symptoms don't appear until later in childhood or during adolescence. Both parents must have abnormal genes to pass on this form of the disease. If both parents carry a gene for this disorder, each child has a 25 percent chance of getting the diseaseType 1 arpkd→ more aggressive and usually causes patient death by age 15.Type 2 milder… will have an onset of hypertension and develop renal fialure at older age than type 1. ***Pain, the most common presenting symptom in ADPKD, may be unilateral or bilateral and range from dull and achy to knife-like, stabbing pain. Pain is caused by blood vessel rupture with bleeding into the cyst or perinephric tissues. As the hemorrhagic cyst empties, the patient may present a sudden onset of hematuria(blood in the urine) ranging from mild to severe and obstructive (Torra, 2009). Gross hematuria is another source of pain.The collaborative management for polycystic kidney disease includes:Pain management to prevent disability from chronic pain or analgesics.Notify health care provider if measures are unsuccessful or if current complaint is a significant change from patient’s past experience of pain.Teach patients that nonsteroidal anti-inflammatory drugs (NSAIDs) pose a hazard to remaining kidney function via further compromise to intrarenal blood flow.Prepare the patient for guided ultrasound drainage of troublesome cysts or for surgical intervention, as appropriate.Blood pressure control to prevent complications.Monitor blood pressure after patient has taken medication, if possible.Early diagnosis and management of infected cysts or parenchymal infection as evidenced by fever, deep tenderness over kidney, diaphoresis, bacteremia, leukocytosis, and bacteriuria (Torra, 2009).Notify health care provider if measures are unsuccessful or if current complaint is a significant change from patient’s past experience of pain.Monitor WBC, hemoglobin, and hematocrit levels.Antibiotic therapy for infected cysts. First line antibiotics for management of cysts in polycystickidney disease:Cephalosporins
Penicillin derivativesAminoglycosidesResistant infection following use of the previously mentioned antibiotics may call for a lipid-soluble antibiotic to penetrate the less permeable cysts:Clindamycin and newer derivatives

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