It's about 100 times the size of a normal kidney
Ms. Zhang, 56, is from Fuyang, Hangzhou. Eight years ago, she found out that she had polycystic kidney in the hospital. At that time, the serum creatinine had reached 160 & mu; mol / L (normally under 83 & mu; mol / L). However, because of the fear of surgery, she had been taking conservative treatment only with drugs.
Over the years, she has been suffering from low back and poor appetite. What's more, her stomach has become bigger and heavier, like a 10 month old twin.
A few days ago, Ms. Zhang went to Hangzhou hospital of traditional Chinese medicine to see a doctor because of her bad stomach. One check blood creatinine, actually as high as 500 & mu; mol / L, has long belonged to the category of uremia.
"The kidney of normal people is usually 10cm * 6cm * 3cm, as large as that of ordinary smart phones. However, the examination found that Ms. Zhang's kidney is 30cm * 30cm * 20cm, and its volume is almost 100 times of that of normal people. Huang Yasheng, deputy director of Urology and physician in charge of Urology in the hospital, said: 'originally, the intestines in the stomach should be large, but Ms. Zhang's whole stomach is almost only left with kidneys, and the intestines become very thin. '
He mentioned that the normal kidney should be as smooth as the pig kidney, but Ms. Zhang's kidney is full of vesicles, each of which is filled with water, like a bunch of giant grapes.
A kidney weighs eight Jin
Patients with polycystic kidney need to be most alert to bleeding, infection and uremia. Unexpectedly, Ms. Zhang had shock not long after she was admitted to the hospital. At last, it was found that it was caused by polycystic renal hemorrhage. Because of the severe bleeding, the minimum hemoglobin was 4G, so Ms. Zhang could only have a nephrectomy.
On November 14, Huang Yasheng performed nephrectomy for Ms. Zhang. In order to make the blade smaller, I first pricked the full blister and then took it out after decompression. "Huang Yasheng said," it's more than 8 Jin. It's a whole washbasin. It's just one of the kidneys. '
At present, he has only removed one of Ms. Zhang's kidneys, while the other has been preserved, Huang said. "Because the other kidney has certain urinary function, and Ms. Zhang's body can't bear to remove two kidneys at the same time, so we kept them. At present, she has begun dialysis. '
Today (November 16), Ms. Zhang has been able to transfer from intensive care unit to general ward, after which she needs to be hospitalized for a period of time.
Huang Yasheng told reporters that the blood creatinine 200 & mu; mol / L is a barrier, beyond which the rate of rise will be very fast, that is to say, the metabolic capacity becomes very bad, which is also an opportunity for interventional therapy.
"If Ms. Zhang had intervened eight years ago to reduce the pressure of the multicapse, the course of her development into uremia could be more than doubled. "Huang Yasheng explained that because the pressure of the vesicles will affect the normal blood supply and filtration function, if punctured to reduce pressure, it can play a role in relieving.
5% - 10% of uremic patients
The incidence of polycystic kidney is about 1 / 1000-1 / 500, accounting for 5% - 10% of uremic patients, Huang said. In addition, polycystic kidney patients are often accompanied by polycystic liver, polycystic ovary, cerebral aneurysm, heart valve disease and so on.
60% of polycystic kidney is inherited by family. It can be divided into autosomal dominant inheritance and autosomal recessive inheritance. Patients with autosomal dominant inheritance usually develop disease at the age of 30-40, while those with autosomal recessive inheritance are often unable to be born or die within a few months.
Therefore, prenatal diagnosis is very important. "If there is a family inherited polycystic kidney, it is recommended to make a genetic diagnosis of the fetus at 10-24 weeks of pregnancy. If the disease gene is carried, it is not recommended to give birth. "If there is only one parent with hereditary polycystic kidney, the risk of children's disease is 50%; if both parents have hereditary polycystic kidney, the risk of children's disease is as high as 75%. '
The remaining 40% of patients with polycystic kidney disease, including Ms. Zhang, are caused by gene mutations.
So, will all patients with polycystic kidney develop uremia? Huang Yasheng told reporters that about 60-70% of patients with polycystic kidney will develop uremia, but if they live long enough, all polycystic kidney will eventually develop uremia.
He said: 'generally speaking, the course of disease from polycystic kidney to uremia without any treatment is about 10 years; if interventional therapy is carried out, the time can be doubled, and some people can control it well and do not continue to develop. '