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Treatment Story: rare case of Autosomal Polycystic Kidney Disease treated in BGS Gleneagles Global Hospital

Bangalore, August 22nd, 2019: Autosomal dominant polycystic kidney disease (ADPKD) is a rare genetic disorder which majorly affects the kidneys and the symptoms begins to show up only by 30 – 40 years of age. It has been noted that, in 90 percent of the cases, people inherit the disease from one affected parent. A few months ago, one patient with such severe case was operated at BGS Gleneagles Global Hospital in Kengeri. Naveen (name changed) , a 47-year-old man and his family, who are resident of Chitradurga, were diagnosed with this rare form of disease called Autosomal Polycystic Kidney Disease.

Autosomal dominant polycystic kidney disease (APKD) is a genetic disorder where 50 percent children of the carrier parents will invariably develop kidney disease. A patient diagnosed with this disease develops small fluid filled sacs called cysts in both the kidneys which eventually lead to kidney failure. It has been estimated that it is the fourth leading cause of acute kidney failure and more than 50 percent of the population with ADPKD will eventually develop kidney failure by the age 50. This disease is not preventable as it is genetic in nature.

Naveen (name changed) was diagnosed with ADPKD way back in his early 30s. He began experiencing some health concerns such as inability to eat food, increased fatigue and weight loss. Later, he consulted a doctor from another hospital and learned that he was suffering from Autosomal Polycystic Kidney Disease (ADPKD) which is a genetically inherited disease that affects the kidney, liver and other organs. Although, people are born with this condition but the disease is not noticeable until the age 30. Naveen had one sister who deceased due to breast cancer, his mother, twin brother and one more sister were diagnosed with the chronic kidney disease. His mother succumbed to kidney failure at the age of 35 and his brother and sister are under the dialysis for the past few years.

Naveen(name changed)  was on dialysis since 11 years and he was registered for deceased donor kidney transplant in 2013. As the days passed Naveen’s health started deteriorating and his brother, who himself is on dialysis, admitted him to the hospital due to his severe abdominal pain and passing of blood in the urine. Naveen’s kidneys were found to be enlarged thrice their normal size and were not functioning properly. Overtime, he developed Hepatitis C infection. Subsequently, he developed heart dysfunction, liver cirrhosis (failure) and bleeding tendencies. He also developed bone-related complications due to long-standing chronic kidney disease.

He had to undergo haemodialysis thrice a week, which was a practical and financial challenge for his ailing brother, who himself is on dialysis for the last 10 years. The panel of doctors and his brother felt by transplanting Naveen’s kidney, the burden would partially come down. Naveen’s case was complex due to his prolonged kidney disease, which led to affecting his liver, heart and bones. After a long wait for an organ he received a kidney from the deceased donor and the transplant was performed immediately without a further delay.

Naveen went through the kidney transplant in July 2019 after a long wait of 8 years for the organ. Even after major complications in the case the nephrology team which was led by Dr. Anil Kumar B.T, Senior consultant Nephrologist & Transplant Physician, in BGS Gleneagles Global Hospital with the support of Dr Farooq, Dr Nitin – Nephrologists, Dr Narendra, Dr Seshagiri Rao and Dr Moin – Transplant surgeons turned this kidney transplant into a success. It took 15 days for his kidney function to improve. After the surgery his health condition has improved, his renal function became normal and he is currently going through physiotherapy. Doctors believe that in couple of months, the bone damaging effects of kidney disease will be alleviated and he would be able to walk again.

Dr. Anil Kumar B.T, Senior consultant Nephrologist & Transplant Physician, BGS Gleneagles Global Hospital says “Naveen and his family have been suffering enormously due to this genetic disorder for the past few years. When he came to the hospital his condition was already worse. He was under the dialysis for 11 years and continued till last month after which he was fortunate enough to receive organ and went through kidney transplant. Due to the long duration of dialysis and CKD, he had developed severe bone weakness and became wheelchair bound.”

Dr Narendra S, Senior Consultant Urologist and Transplant Surgeon, BGS Gleneagles Global Hospital, said, “Doing Renal transplantation in CKD patient due to ADPKD is really challenging, because of huge native kidney and no space to keep the graft. This patient underwent bilateral Nephrectomy 6 years back for discomfort caused by enlargement of kidney. We were able to do renal transplantation in spite of adhesion due to previous surgery, due to vast experience in doing complex cases routinely and state-of- the-art facilities in our center.”

Dr. Anil K, Senior consultant Nephrologist & Transplant Physician, BGS Gleneagles Global Hospital says “A severe genetic disease like ADPKD cannot be prevented; however, renal failure progression can be slowed down by adopting a healthy lifestyle. You can maintain the kidney functions by managing the blood pressure, by consuming low salt diet; avoid smoking and drinking of alcohol and most importantly by maintaining a healthy weight with constant and regular exercise.”

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