Resource Guide
A guide to help PKDF Volunteers
Are you looking for a resource to share? The PKD Connect staff is here to help volunteers find resources to share with the PKD community.
ADPKD
Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common, life-threatening genetic diseases. In ADPKD, fluid-filled cysts develop and enlarge in both kidneys, eventually leading to kidney failure. It is the fourth leading cause of kidney failure and more than 50 percent of people with ADPKD will develop kidney failure by age 50. Once a person has kidney failure, dialysis or a transplant are the only options.
Unlike some genetic diseases, ADPKD does not skip a generation meaning it often affects many people in one family. Approximately 10 percent of the people diagnosed with ADPKD have no family history of the disease, with the disease developing as a spontaneous (new) mutation. Once a person has ADPKD, even through a spontaneous mutation, they have a 50 percent chance of passing it on to each of their children.
PKD Basics
ARPKD
https://pkdcure.org/what-is-arpkd/
Autosomal recessive polycystic kidney disease (ARPKD) is a rare genetic disorder occurring in approximately 1 in 25,000 children. It affects boys and girls equally and can cause death in the first month of life. If a child with ARPKD survives the newborn period, the chances of survival are good. For these children, approximately one-third will need dialysis or transplantation by the age of 10.
PKD Basics
Biopsy
PKD is usually not diagnosed by biopsy. Usually, patients are diagnosed by ultrasound.
Blood pressure
pkdcure.org/what-is-pkd/adpkd/what-are-the-symptoms/
Blood pressure is a measurement of the force of the blood as it flows through the body.
High blood pressure or hypertension affects about 60 -70 percent of people with ADPKD and begins early in the course of the disease. Many times, the increase in blood pressure will be the first sign of ADPKD and is the primary reason a person gets tested.
High blood pressure should be treated aggressively. If left untreated, hypertension causes further damage to the kidneys, enlarges and thickens the heart muscle and increases the risk for strokes and other cardiovascular events.
Resources:
Webinar – The HALT_PKD study: What do the results of this study mean for me?
pkdcure.org/resource/halt-pkd-study-results/
Webinar – Hypertension and HALT PKD Study Results
youtube.com/watch?list=PLm8pivZkga9iPwY5vZcU8TBI4F5xHzWoQ&v=M6ufGZwmLok
Caffeine
pkdcure.org/living-with-pkd/nutrition/
There is no direct evidence that caffeine will damage your polycystic kidneys. However, studies of PKD cells grown in a lab have shown that caffeine-like substances promoted cyst growth in PKD. At this time, it may be wise to limit caffeine intake to less than 200 to 250 mg per day.
Caregivers
https://connect.pkdcure.org/caregivers/
Caring for a loved one with PKD can be a stressful. It is easy to feel overwhelmed and unable to cope. Find more information about symptoms related to stress and self-care at the link above.
Caregivers need self care, too!
Talking about PKD – Patients and caregivers share experiences talking with friends and family
Chronic kidney disease stages
Clinical trials
Patients play a key role in the research and development process by volunteering to participate in clinical studies. From observational studies to clinical trials, you can help researchers unlock the secrets of PKD and find a treatment by participating in a study
The link provided will direct you to a list of studies that are currently recruiting participants. Use the contact information provided to find out how to participate.
Children and PKD
https://pkdcure.org/what-is-adpkd/parents-of-children-with-pkd/
PKD affects children as well as adults. Cystic kidney disease in children can dramatically affect quality of life for children who have it. Our PKD Parents Chapter supports parents of children with PKD.
Managing family life when your child has PKD
How to talk to children about PKD
Basics of clinical care for children with ARPKD and ADPKD
Advocating for your child – Communication is key
Day to day living for children with PKD
ARPKD Patient Handbook
ADPKD Patient Handbook
Genetics – PKD genes and how they work
Cysts
https://pkdcure.org/what-is-adpkd/what-are-cysts/
A cyst in the kidney begins as an outpouching of the nephron, similar to a blister, and can occur any where along the length of the nephron. Cysts can also form in other organs, with the liver being the most common site.
Creatinine
Creatinine is a measure of kidney function. It is a waste product of muscle metabolism (the work the muscles do). After creatinine leaves the muscles, it enters into the blood, then is filtered by the kidneys and ends up in the urine. There is always some creatinine in the blood and some in the urine. When there is a loss in kidney function, the kidneys do not clear creatinine from the blood as efficiently as they once did. This causes an increase of creatinine in the blood, which can be measured by a simple blood test.
Diagnosing ARPKD
Many children with ARPKD are diagnosed before birth if prenatal ultrasound shows enlarged, bright-appearing or echogenic kidneys and low amniotic fluid levels.
Children diagnosed with ARPKD later in childhood generally have milder disease progression.
What is ARPKD?
Basics of clinical care for children with ARPKD and ADPKD
Genetics — PKD genes and how they work
ARPKD Patient Handbook
ADPKD Patient Handbook
Diagnosing ADPKD
pkdcure.org/what-is-pkd/adpkd/how-is-adpkd-diagnosed/
Currently, there are three main clinical tests that can be used to diagnose a person with PKD: ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI).
Ultrasound is the most common and least costly screening method for ADPKD.
Testing children
pkdcure.org/what-is-pkd/adpkd/how-is-adpkd-diagnosed/
The question of whether or not to have your child / children tested for PKD is a difficult and personal one. Once a diagnosis is confirmed by imaging or genetic testing, it becomes part of an individual’s health records.
PKD patients get diagnosed at all different ages.
Dialysis
pkdcure.org/living-with-pkd/dialysis/
Dialysis is a kidney replacement option, when transplant is not immediately available, that does some of the things healthy kidneys do. It is needed when your own kidneys fail or can no longer function well enough to take care of your body’s needs.
There are two main types of dialysis: hemodialysis and peritoneal dialysis.
Dialysis 101
Kidney Failure – What to expect
Financial assistance resources
connect.pkdcure.org/resources-and-education/financial-assistance
The cost of managing chronic kidney disease can be expensive, especially once your disease progresses to kidney function decline and kidney failure. We have gathered some financial assistance resources that might help you afford different aspects of your care.
How will I know when I need a transplant or dialysis?
Dialysis 101
Kidney failure – what to expect
How do I find a dialysis center in my area?
To find a dialysis center near you and find out how it ranks in terms of quality and care, you can go use the “Dialysis Center Comparison” tool provided by the Department of Health and Human Services. To access this tool, click here.
If you are looking to change dialysis facilities because you are not happy with your current center, keep in mind you may also need to change doctors.
Genetics and genetic testing
pkdcure.org/what-is-pkd/adpkd/how-is-adpkd-diagnosed/
Autosomal dominant polycystic kidney disease (ADPKD) is caused by mutations in two genes. Mutations of the first gene, PKD1, account for about 85 percent of patients while mutations of the second gene, PKD2, account for the remaining patients. Recently, another gene thought to case the disease, GANAB, was discovered in a small number of patients.
https://pkdcure.org/what-is-pkd/adpkd/how-is-adpkd-diagnosed/
Autosomal recessive polycystic kidney disease (ARPKD) is caused by a mutation in the PKHD1 gene. In recessive disorders such as ARPKD, the child must inherit a copy of the PKHD1 gene from each parent. Since the parents each have only one copy of the disease gene, they do not have the disease and are referred to as “carriers.” Parents carrying the mutated PKHD1 gene have a 25 percent chance that each child will have ARPKD. There is also a 50 percent chance each child will not have ARPKD but will be a carrier of the disease.
To find information about genetic testing visit, Financial Resources page.
Resource Library:
Genetics testing panel
Genetics – How your genes impact your family tree
Genetics: PKD genes and how they work
PKD genetics
Insurance and Medicare
Employer Group Health Plan (EGHP)
If you or your spouse are working, you may be eligible for insurance through your employer. Employers with 50 full-time employees or more must offer insurance to their employees. Children up to age 26 are eligible under parents’ insurance plan.
Affordable Care Act
If you do not have medical insurance through your employer, you can apply for individual insurance plans through the Affordable Care Act Marketplace. For more information, visit healthcare.gov.
Medicare
Patients that have ESRD (end stage renal disease) can apply for medicare coverage regardless of age.
medicare.gov/people-like-me/esrd/esrd.html
Medigap is extra health insurance that you buy from a private company to pay health care costs not covered by Original Medicare, such as co-payments, deductibles, and health care if you travel outside the US.
medicare.gov/supplement-other-insurance/when-can-i-buy-medigap/when-can-i-buy-medigap.html
Kidney Donor
pkdcure.org/living-with-pkd/transplant/about-donating-your-kidney/
For more information about being a kidney donor, please contact a transplant center near you and ask for the living donor coordinator.
Resource Library:
Living Donation
Guide to Transplantation & Living Donation
Kidney failure
Signs of kidney failure are:
- Fatigue
- Poor appetite
- Nausea/vomiting
- Trouble concentrating (in severe cases, confusion)
- Dry, itchy skin, especially if phosphate is high
- Funny taste in your mouth; food tastes funny, metallic
- Muscle cramps at night
- Swelling in feet and ankles
Understanding your risk for ADPKD progression
Best practices for disease management – working with your doctor
Kidney failure – what to expect
Kidney stones
Kidney stones occur in about 20 to 30 percent of people who have ADPKD as compared to one to two percent of the general population.
The symptoms of kidney stones are severe pain in the back, side or into the groin. Often there will be blood in the urine when passing a kidney stone.
Kidney Stones webinar
ADPKD Patient Handbook
Medications to avoid
pkdcure.org/living-with-pkd/working-with-your-doctor/
In general, you should avoid any medication that could harm your kidneys or affect your blood pressure. This includes:
- Non-Steroidal Anti-inflammatory Agents, such as Advil, Motrin and Aleve: If you have pain, use can use safe doses of Tylenol or Ultram.
- Cold or allergy pills with pseudafed (pseudoephedrine): These can raise your blood pressure.
- Over-the-counter diet pills: These may contain diuretics or stimulants.
Herbal supplements – discuss any herbal supplements with your physician
As always, you should consult your physician/nephrologist before taking any over-the-counter medications and supplements. He or she can help you weigh the risks and benefits, depending on your degree of renal dysfunction.
Best practices for disease management – Working with your doctor
ADPKD Patient Handbook
Nephrectomy — kidney removal
pkdcure.org/living-with-pkd/donating-pkd-affected-kidneys-for-research/
Nephrectomy is a surgery to remove your kidney. The decision whether or not to have a nephrectomy should be made with your physician on a case by case basis.
Nephrectomy surgery — Understanding risks and benefits
Nutrition
pkdcure.org/living-with-pkd/nutrition/
Currently no specific diet has been proven to slow progression of PKD. It is, however, ideal to eat a balanced and healthy diet to maintain optimal body conditions. A healthy body is able to fight infection better, and bounce back faster.
Cooking Well: Delicious, everyday recipes for the PKD family
Nutritional Considerations for PKD Patients
Managing nutrition as dietary needs change from pre-dialysis to post transplant
Pain management
pkdcure.org/living-with-pkd/chronic-pain-management/
Chronic pain is one of the most common problems for patients with PKD. The pain is usually in the back or the side and occasionally in the stomach. It can be intermittent and mild requiring only occasional pain medicine such as acetaminophen (Tylenol). However, in a small number of patients with severe PKD, the pain can be constant and more severe.
If you are experiencing pain, it is important to consult your physician.
Pain Management
ADPKD Patient Handbook
Pre-implantation genetic diagnosis (PGD)
https://pkdcure.org/what-is-arpkd/how-is-arpkd-diagnosed/
This is an early form of genetic diagnosis that involves the detection of specific genetic abnormalities in single cells taken from fertilized human embryos. The PGD procedure involves in vitro fertilization whereby eggs harvested from a mother are fertilized in a laboratory with the father’s sperm. Then, the fertilized embryos are tested for ARPKD by removing one or two cells for genetic analysis. Embryos that are diagnosed as free of the disorder are then placed in the uterus with the intent to initiate a pregnancy.
Family planning and reproductive success
Pregnancy and PKD
pkdcure.org/living-with-pkd/pregnancy-and-pkd/
The diagnosis of ADPKD is no longer only made years after a person has had a family. The use of noninvasive ultrasonography has made the testing for ADPKD safe for all ages. Thus, screening specifically for ADPKD or finding evidence of ADPKD while doing an ultrasound for other reasons has made early diagnosis a more common occurrence. As the age of diagnosis is lower, an understanding of the risks of pregnancy in women with ADPKD is important.
Generally, women with ADPKD who have normal blood pressure and normal kidney function have uneventful pregnancies and deliver healthy babies. Risk factors associated with pregnancy and ADPKD are due to increased blood pressure.
It is important for a woman with ADPKD to be closely monitored during pregnancy whether she has hypertension or not.
The decision to have children is a very personal one. It is important to discuss concerns with your doctor.
Family planning and achieving reproductive success
ADPKD Patient Handbook
Spontaneous mutation
pkdcure.org/what-is-pkd/adpkd/
Approximately 10% of patients with PKD are the result of a spontaneous mutation meaning that there is no family history of the disease and the disease is due to a spontaneous mutation of the PKD1 or PKD2 gene.
Slow or stop progress of PKD
There are several things patients can do to try to delay the onset of renal failure:
- Control blood pressure.
- Control cardiovascular risk factors by maintaining a healthy diet, maintaining healthy body weight, exercising regularly, avoiding smoking, etc.
- As with any other kind of kidney disease, avoiding medications that could possibly injure the kidneys. Discuss all medications with your physician.
Understanding your risk for ADPKD progression
Best practices for disease management – working with your doctor
Symptoms of ADPKD
pkdcure.org/what-is-pkd/adpkd/what-are-the-symptoms/
Common symptoms include:
- High blood pressure
- Chronic pain or heaviness in the back, sides or abdomen
- Blood in the urine
- Urinary tract infection (UTI)
- Kidney stones
PKD Basics
ADPKD Patient Handbook
Symptoms of ARPKD
https://pkdcure.org/what-is-arpkd/what-are-the-symptoms/
Prenatal symptoms
- Diminished amniotic fluid levels during pregnancy
- Enlarged kidneys on fetal ultrasound
- Lung immaturity and functioning issues
Symptoms immediately after birth
- Enlarged kidneys due to cysts
- Breathing problems due to lack of space because of enlarged kidneys and decreased urine production. Ventilation is frequently required to sustain life.
- Excessive urine production
- Hypertension
- Growth problems
- Congenital hepatic fibrosis
- Enlarged spleen with low red blood cell, white blood cell and platelet counts
Basics of clinical care for children with ARPKD and ADPKD
ARPKD Patient Handbook
Transplantation
pkdcure.org/living-with-pkd/transplant/pre-transplant-preparation/
When you and your doctor agree it is time for you to be evaluated for a transplant, you undergo a series of tests to assess your options. You’ll be evaluated for potential issues like heart disease, obesity, and diabetes. A social worker or transplant coordinator will discuss the logistics with you as well; things like transportation, housing, financial and family support will all be considered.
Resource Library:
Transplantation – From evaluation to transplant surgery
Preemptive transplant panel discussion
Post-transplant- What to expect
Role Specific Resources
Contact us
Nicole Harr
Sr. Director of Community Engagement
nicoleh@pkdcure.org
Lavonne Nichols
Community Engagement Strategist
lavonnen@pkdcure.org
Page last reviewed March 2022