Polycystic kidney disease during pregnancy

　　The etiology of polycystic kidney disease during pregnancy is not yet clear. Recently, it has been considered that it is caused by the transformation of existing renal tubular diverticula. During the process of embryonic development, the kidney tubules and collecting tubes or renal tubules and renal calyces are all or partially connected before the kidney development stops, the secretion of urine is blocked, and the glomeruli and renal tubules produce retention cysts.

　　Polycystic kidney disease during pregnancy can be accompanied by other organ cystic lesions, such as polycystic liver, occasionally cysts appear in the pancreas and ovaries, often with structural abnormalities of the gastrointestinal tract, blood vessels, and heart valves.

　　Polycystic kidney disease is a genetic disease, and generally, the disease has the following symptoms:

　　1, Pain

　　Back pain or abdominal pain is the most common symptom, mostly painless or dull pain, which can radiate to the lumbar or lower abdomen. Pain may suddenly worsen, often due to intracystic hemorrhage or secondary infection.

　　2, Hematuria and proteinuria

　　Some patients have hematuria, which may be microscopic hematuria or gross hematuria. Hematuria is mainly caused by the rupture of the blood vessels in the cyst wall due to excessive traction. Most patients have proteinuria, which is usually below 2g/24 hours.

　　3, Hypertension

　　Some patients may have hypertension, pregnant women often have gestational hypertension during pregnancy, which can cause the condition of polycystic kidney disease to worsen.

　　4, Abdominal mass

　　As the uterus grows during pregnancy, it is not easy to palpate an enlarged polycystic kidney in the abdomen. However, in patients with a thin body during the non-pregnant period, 50% to 80% can palpate an abdominal mass.

　　5, Infection

　　Polycystic kidney disease often occurs with urinary tract infections. Acute infection or purulent infection may be manifested as chills, high fever, frequent urination, purulent urine, etc.

　　6, Renal failure

　　Late cases may cause renal failure due to the destruction of renal parenchyma caused by factors such as cyst compression and concurrent pyelonephritis.

　　Polycystic kidney disease during pregnancy is a congenital disease, therefore, there are no very effective preventive measures. The main measures to reduce the occurrence of the disease are to actively do pre-natal examinations, discover problem fetuses in time, and take timely measures according to the situation.

　　The etiology of polycystic kidney disease during pregnancy is not yet clear. Generally, the disease can be diagnosed by the following examinations:

　　1. Urinalysis:Early urine routine is normal, and microscopic hematuria may occur in the middle and late stages. Some patients may have proteinuria, accompanied by leukocytes and pus cells when accompanied by stones and infection.

　　2. Urinary osmolality measurement:Renal concentrating function impairment can appear in the early stage of the disease.

　　3. Renal function test:Serum creatinine and blood urea nitrogen increase progressively with the loss of renal compensatory function, and creatinine clearance rate is also a relatively sensitive index.

　　4. Abdominal flat film:The renal shadow is enlarged and irregular in appearance. X-rays during pregnancy have a certain impact on the fetus, so they are not used as an auxiliary diagnostic method for polycystic kidney disease during pregnancy.

　　5. Ultrasound:Show numerous fluid dark areas in the renal area.

　　6. IVU:The bilateral renal pelvis and calyces are compressed and deformed,呈蜘蛛状, the calyces become flat and wide, the calyceal neck is elongated and thinned, often bending, and in cases of renal insufficiency, the renal imaging time is delayed or not visible.

　　7. CT:Show the enlargement of the kidneys, with a lobulated shape, composed of many thin-walled cysts filled with fluid, and liver, spleen, and pancreas cysts may also be found at the same time.

　　There are no special dietary requirements for patients with polycystic kidney disease during pregnancy, and normal diet is sufficient. Pay attention to a rich diet and balanced nutrition. Ensure the body's normal metabolic needs for calories, proteins, and vitamins. Increase the intake of vegetables and fruits appropriately. In terms of health care, it is important to relax, build confidence, maintain a good mental state, and actively cooperate with the doctor's treatment.

　　Polycystic kidney disease itself has no special treatment method, and the prognosis is often poor. However, with the progress of kidney transplantation surgery in recent years, the treatment prospects of polycystic kidney disease have improved significantly.

　　1. Pre-natal Treatment

　　Pregnancy complicated with polycystic kidney disease is a high-risk pregnancy, prone to complications such as pregnancy-induced hypertension and pyelonephritis during pregnancy, so regular check-ups and follow-ups should be carried out. In addition to routine examinations, attention should be paid to changes in renal function, actively prevent and treat pregnancy-induced hypertension, and prevent the deterioration of polycystic kidney disease. When urinary tract infection occurs, broad-spectrum antibiotics should be used.

　　2. Termination of Pregnancy

　　Young and uncomplicated pregnant women can often achieve full-term pregnancy and deliver vaginally. If renal function deteriorates progressively, termination of pregnancy should be considered, and cesarean section can be performed for those who cannot deliver vaginally in the short term.