Impact of alcohol on patients with polycystic kidney disease

Polycystic kidney disease

Polycystic kidney disease (PKD) is a genetic disorder in which many fluid-filled sacs (cysts) form in both kidneys. The kidneys are larger than usual, but have less functioning kidney tissue. As a person with PKD ages, the cysts grow larger and a reduction of blood flow and scarring of the kidneys results. Kidney stones sometimes develop, and eventually it is likely that a person will develop kidney failure.

The genetic defect that causes PKD also can cause cysts to develop in other organs, such as the liver, colon, and pancreas. Sometimes the heart valves also are affected. Diverticulosis is common in people with PKD. In children with the recessive form of PKD, the abdomen will protrude from the large cysts. The liver, pancreas, and spleen also are affected by the autosomal recessive form of PKD.

Most infants with the recessive form of PKD will have failure to thrive and will remain smaller than average size throughout childhood. Severely affected newborns may die shortly after birth from kidney failure, which then leads to poor development of the lungs. Children with this recessive form of PKD usually develop high pressure in the blood vessels connecting the intestines and the liver, and eventually both kidney and liver failure result. These children must eat a very nutritionally balanced diet, sometimes with commercial nutrition supplements, to increase growth. In addition, sometimes growth hormones are used.

The dominant form of PKD develops very slowly, with symptoms starting in early or middle adulthood. Symptoms include pain in the abdomen or flank, blood in the urine, headaches, frequent urination, and cramping pain from the development of kidney stones. In fully developed autosomal dominant PKD, the kidney may weigh as much as 30 pounds. Frequent urinary tract infections worsen kidney failure. At least half of all people with PKD will have hypertension at the time of diagnosis. As many as 10% of people with PKD have brain aneurysms, which often lead to strokes.

No diet will prevent the formation of cysts. A moderate, low-sodium diet to prevent obesity and hypertension, which can lead to serious complications, is recommended for many patients with PKD.

Common lab tests
Creatinine
Creatinine is used as a measure of kidney function. It is a waste product of muscle breakdown, and excretion is decreased as kidney function worsens. A doubling of creatinine level represents a 50% decrease in kidney function. It is unaffected by dietary protein intake.

Blood urea nitrogen (BUN)
BUN is another lab test used to measure kidney function. A high BUN level is known as “uremia.” Causes may include increased protein intake, dehydration, and some medical conditions. Symptoms of uremia can include nausea, vomiting, diarrhea, loss of appetite, and confusion. A decreased level results from decreased dietary protein intake, loss of protein, and overhydration.
Alkaline phosphatase (alk phos)
Alk phos is a type of protein found in bone, kidneys, intestines, teeth, and plasma. It is released from bone when calcium is withdrawn from the skeleton, so increased levels mean that rate of bone turnover and demineralization has increased.

Hemoglobin and hematocrit (Hgb and Hct)
Hemoglobin is the protein-iron compound that carries oxygen in the blood. Levels are decreased with renal disease. When levels are low, physicians often prescribe either iron supplementation or erythropoietin (EPO), which is a hormone produced by the kidney that promotes the formation of red blood cells in the bone marrow. Hematocrit is a measure of packed cell volume as a percent of total blood volume. Low levels result from decreased EPO production or less maturation of red blood cells. It also is caused by blood loss. High levels usually result from getting too much EPO.

Calcium
Low calcium levels can result in tingling fingers, abdominal cramps, convulsions and tetany, and cardiac arrest. High calcium levels can cause muscle weakness, lethargy, and coma. Some people with PKD require calcium supplementation.

Alcohol and PKD
No major studies have looked at alcohol consumption and PKD. When looking at other kidney diseases, alcohol does not seem to have much of an impact. Lifestyle factors, such as tobacco use, physical activity, and obesity, most likely have more of an impact than alcohol. Unfortunately, alcohol is linked to hypertension, which is known to accelerate the decline in kidney function. Even light amounts of alcohol consumption drank on a regular basis seems to increase blood pressure.

If you are on medication for your blood pressure, you should know that alcohol can interfere with these drugs. Alcohol consumption can damage kidney function, especially if you also have liver disease. Alcohol consumption may adversely affect the regulation of fluids and electrolytes by the kidneys. Chronic intake of large amounts of alcohol can lead to kidney and liver failure.

Proper dietary and nursing care play an important role for management of Polycystic Kidney Disease (PKD) and slowing down progression of the illness condition. Drinking alcohol is what many people like, well then, when diagnosed as PKD, should people continue to drink alcohol?

People with Polycystic Kidney Disease are suggested to stop drinking alcohol. Alcohol can do harm to the health in PKD people in various ways. As we have known, PKD is an inborn kidney disorder characterized by clusters of cysts existing in the kidneys. The enlarging kidney cysts can oppress surrounding renal tissues, cause renal ischemia, elevate blood pressure and damage the kidneys. Management of high blood pressure is a tough job for PKD because hypertension worsens damage on the kidneys. Drinking alcohol can raise people’s blood pressure thus making BP difficult to be controlled.

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