1.1.4.2. Symptomatic treatment of ADPKD Cases of ADPKD require a symptomatic treatment by prophylactic and supportive measures such as tight blood pressure management; also include adequate pain control, antibiotics for urinary tract infections, sufficient fluid intake, and avoidance caffeine and smoking. Urinary tract infections could be treated by using cyst-penetrating antibiotics, which is lipophilic agents penetrate the cysts consistently such as trimethoprim-sulfamethoxazole and fluoroquinolone (Elzinga et al., 1987 and Elzinga et al., 1988). 11.126,127, Whereas cyst hemorrhages require a careful administration with bed rest, analgesics and water. Also cases of nephrolithiasis require prophylactic measures, which include good water intake, such as potassium citrate was suggested for three causes of stones associated with ADPKD, uric acid lithiasis, hypocitraturic calcium oxalate nephrolithiasis, and distal acidification defects (Torres et al., 2007). 9A. In severe cases, stone can be treated by alternative approaches, which include extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy (Christian et al., 2010)11. …show more content…
Also use of narcotic analgesics must be retreated for acute episodes to minimize the potential for dependence (Grantham, 1992) 11.130. When conservative measures fail, surgical interventions ranging from cyst aspiration and sclerosing agents to laparoscopic or surgical cyst fenestration can be considered. Laparoscopy can be carried out only on dialysis-dependent patients as it eliminates any remaining renal function, essentially decreasing GFR to zero (Lee et al., 2003)