Complications of Polycystic Kidney Disease

It is back to another long journey to the United Kingdom. The only difference is that, this trip is neither for “work” nor “pleasure”. In fact, it’s a journey of “self-reflection” as I am attending a medical school reunion at Cambridge after 25 years (can’t believe it has been so long!).

I keep no secret in the previous articles that I loathe long plane journeys. Under the normal circumstances, I would have used the opportunity to catch up with the latest movies.

As I am overwhelmed by paperwork recently, I have decided not to be lured by the mindless Hollywood temptations and straightaway got into my work.

When the plane was about to take off, I ploughed through the international press; I was saddened by the media coverage of the refugee crisis in Europe as this is potentially a problem beyond control.

We also have our share of asylum seeking refugees near our shores recently. Statistics released by the UNHCR  showed there were more than 150,000 registered asylum seekers taking refuge from political persecution up to May 31.

A vast majority of the refugees, comprising ethnic Chin and Rohingya from Myanmar, as still stateless and awaiting “processing” in Malaysia. As the media coverage of the issue contracted, I often wonder if the actual problem is under controlled or underwrapped?

Malcolm X, born Malcolm Little, was one of the most influential African American in history. Orphaned early in life, he was a courageous advocate for rights of blacks, and was accused of preaching racism and violence. Malcolm X once said: “The media is the most powerful entity on earth. They have the power to make the innocent guilty and to make the guilty innocent. And that’s power. Because they control the minds of the masses.”

I draw parallel comparisons with the important issues of refugee crisis and its media attention with numerous medical conditions. The perception how benign a medical diagnosis is not always a true reflection of the actual severity of the condition.

In fact, in many instances, the recognition of the disease is only the tip of the iceberg. The constant coverage discussion of the condition is often the only way to bring awareness and empowerment to the sufferers.

This week, we deal with the benign perception of the cause of sexual dysfunction – it might be the beginning of a nightmare that can spiral out of control.

Dear Dr G,

I am Josh, aged 36, and have been rather puzzled by my sexual problems recently.

I visited my doctor when I experienced back pain last year.

My doctor diagnosed kidney infections and was rather concerned about my high blood pressure, which I am completely unaware of.

The infection is now gone but despite two different medications, I was still unable to control my blood pressure. I was then referred to the specialist who scanned me and diagnosed polycystic kidney disease, which I understand is a benign medical condition that only requires regular monitoring.

After starting the blood pressure tablets, I started having erectile dysfunction. I am hoping to stop the medications. Is that a good idea?

Josh

Polycystic kidney disease (PKD) is a genetic disorder characterised by the development of clusters of cysts developed within the kidneys. Although the cysts are generally perceived to be benign, as they are mere water-like fluid within numerous round sacs, the wider implications of the PKD is far more serious, as this is also a genetic condition affecting numerous other organs.

It is not uncommon for people to have PKD for years without knowing about the disease. PKD often developed for patients between 30 and 40 years old. As the condition is autosomal “dominant” genetic disease, only one of the parents need to have the disease and each child will have a 50% chance of being affected.

The degree of severity of PKD is quite variable, however, the potential complications of the disease can be detrimental. As this genetic defect can affect more than kidneys, the other organs such as liver, brain and heart have to be monitored stringently.

Elevated blood pressure is the commonest complications affecting the patients. The hypertension may result in early presentation of erectile dysfunction (ED), however, it can also be serious enough to cause early heart attacks or strokes.

Progressive loss of kidney functions is also common in half of the affected populations, as the cysts may interfere with the filtration ability of the kidneys. The other serious complication of PKD is the development of an aneurysm in the brain (Berry Aneurysm) than can result in hemorrhagic strokes in younger patients.

Other complications include pregnancy complications, cystic liver, heart valve abnormality, colon problems and chronic back pain. PKD is an incurable medical condition. Sufferers must take control of lifestyle changes and seek medical therapy to reduce the damage to the kidneys and prevent serious hypertension-related complications.

Although, blood pressure control with medications can be catered to suit young patients without compromising on their sexual health, compliance is the key to control. Besides, empowerment with the understanding of the overall implications of this condition with low salt diet, regular exercise, weight maintenance and avoiding smoking may help to prevent the condition from getting out of control.

“You may not control all the events that happened to you, but you can decide not to be reduced by them”, said Maya Angelou, the famous American author and poet. Although the current state of the world or many medical conditions may not be ideal, the “power” of the media can continue to keep us engaged and empowered. This is the only way to prevent the problems spiraling out of control and help us not to be reduced by the state of the affairs.