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Published on: June 23, 2015
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Pain Management in Autosomal Dominant Polycystic Kidney Disease: Clinical Challenges and a Stepwise Algorithmic
Abdul Hamid Borghol1,2, Fadi George Munairdjy Debeh1,2, Ahmad Ghanem1,2
1Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Jacksonville, Florida.
Kidney360
|July 7, 2025
Summary
Autosomal dominant polycystic kidney disease (ADPKD) pain significantly impacts quality of life. Surgical intervention, like nephrectomy, can offer substantial pain relief and improve patient outcomes when other treatments fail.
Area of Science:
- Nephrology
- Genetics
- Pain Management
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder, caused by mutations in PKD1 or PKD2.
- ADPKD leads to kidney cyst formation, enlargement, and potential kidney failure.
- Pain is a prevalent and quality-of-life-limiting symptom in ADPKD, often stemming from cyst growth or complications.
Purpose of the Study:
- To review the causes, manifestations, and management strategies for abdominal and flank pain in ADPKD.
- To present a case study of successful pain management through nephrectomy and partial hepatectomy in a patient with refractory ADPKD pain.
- To provide a clinical algorithm for guiding pain management in ADPKD patients.
Main Methods:
- Literature review of ADPKD pain causes, symptoms, and treatments.
- Case presentation of a 29-year-old female with ADPKD and chronic, refractory flank pain.
- Description of surgical intervention (nephrectomy and partial hepatectomy) and its impact on pain and quality of life.
Main Results:
- The case patient experienced significant pain improvement and enhanced quality of life post-surgery.
- A stepwise algorithm for managing ADPKD-related pain was developed.
- Multidisciplinary approaches, including pharmacological and non-pharmacological interventions, are crucial for effective pain control.
Conclusions:
- Surgical interventions like nephrectomy can be effective for refractory ADPKD pain when conservative measures fail.
- A structured approach to pain management is essential for improving the quality of life in ADPKD patients.
- Further research into novel pain management strategies for ADPKD is warranted.
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