Disease
Polycystic Kidney Disease (PKD) is a genetic disorder characterized by the formation of multiple fluid-filled sacs or cysts within the kidneys. Over time, these cysts enlarge, multiply, and distort the normal kidney structure, leading to an increase in kidney size and a gradual decline in function.
Unlike simple kidney cysts (which are common and harmless with age), the cysts in PKD are numerous and progressive, often interfering with how the kidneys filter blood and maintain fluid and electrolyte balance. As the cysts grow, they compress surrounding tissue, impair blood flow, and trigger scarring, which ultimately leads to chronic kidney disease (CKD) or, in severe cases, end-stage renal disease (ESRD).
There are two main forms of PKD:
Autosomal Dominant Polycystic Kidney Disease (ADPKD): The most common type, accounting for about 90% of cases. It typically develops in adulthood, though cysts may be present from birth. If one parent carries the defective gene, each child has a 50% chance of inheriting it.
Autosomal Recessive Polycystic Kidney Disease (ARPKD): A rarer, more severe form that manifests in infancy or early childhood, often causing enlarged kidneys and liver complications.
PKD isn’t confined to the kidneys alone, it can affect other organs too. Cysts may develop in the liver, pancreas, or spleen, and patients may experience complications such as high blood pressure, aneurysms, or heart valve abnormalities.
While there’s currently no cure for PKD, early diagnosis and comprehensive management can significantly slow progression and improve quality of life.
Dr Anish Kr. Saha’s care for PKD goes beyond medical control. His approach is rooted in precision medicine, identifying the rate of cyst growth, managing complications, and providing tailored lifestyle and dietary guidance. His mission is to help patients live well, live longer, and preserve kidney function for as many years as possible.
Symptoms
PKD often progresses silently in its early stages, with cysts developing unnoticed for years. As the cysts enlarge, symptoms begin to appear, usually between the ages of 30 and 50 in ADPKD.
Common symptoms include:
Flank or back pain: Often dull and persistent, caused by enlarged kidneys or cyst pressure.
Abdominal fullness or discomfort: Due to the physical expansion of the kidneys.
High blood pressure (hypertension): One of the earliest and most common symptoms.
Blood in urine (hematuria): Caused by ruptured cysts or associated stones.
Frequent urination: As the kidneys struggle to maintain balance.
Pain during urination or recurrent urinary tract infections (UTIs).
Kidney stones: Common due to altered urine chemistry.
Swelling in ankles, feet, or hands: Sign of declining kidney function.
Fatigue and weakness: From toxin buildup or anemia.
Headaches or dizziness: Can signal high blood pressure or, rarely, aneurysms.
In some cases, PKD also affects other organs leading to:
Liver cysts: Causing discomfort or fullness.
Heart valve issues: Particularly mitral valve prolapse.
Diverticulosis: Formation of small pouches in the colon.
The disease tends to progress gradually. For many, symptoms like mild flank pain or fatigue may seem insignificant until kidney function begins to drop noticeably.
Dr Anish Kumar Saha, the best nephrologist in Siliguri, emphasizes routine monitoring and imaging, even in the absence of symptoms. Regular follow-ups help detect subtle changes early, ensuring proactive intervention before cyst growth begins to impair kidney function.
Causes
The root cause of Polycystic Kidney Disease lies in genetic mutations that alter how kidney cells grow and divide.
1. Genetic Mutations:
PKD is inherited due to mutations in specific genes that regulate kidney structure and function:
ADPKD: Caused by mutations in either the PKD1 gene (responsible for ~85% of cases) or the PKD2 gene. PKD1 mutations tend to cause a more aggressive form of the disease, with earlier onset and faster progression.
ARPKD: Caused by mutations in the PKHD1 gene, affecting infants and young children.
These genetic errors cause kidney cells to produce abnormal proteins, leading to fluid accumulation and cyst formation that disrupts the kidney’s normal filtering network.
2. Family History:
Having a parent with PKD significantly increases the likelihood of developing the condition. However, new (spontaneous) mutations can also occur in individuals without a known family history.
3. Secondary Triggers:
Although the disease is primarily genetic, certain factors can accelerate cyst growth or worsen kidney damage, such as:
Poor blood pressure control.
Recurrent urinary tract infections.
Kidney stones or urinary obstruction.
High salt or protein-heavy diets.
Smoking and dehydration.
Dr Anish Kumar Saha, the best nephrologist in Siliguri, has a management philosophy that combines genetic understanding with environmental awareness. He ensures that patients not only know why PKD occurs but also how lifestyle and preventive habits can influence its pace.
When to See a Doctor
Because PKD develops gradually, early consultation with a nephrologist is crucial, especially for those with a family history. You should see Dr Anish Kr. Saha, if you experience any of the following:
Persistent or recurring back or side pain.
High blood pressure that is difficult to control.
Blood in the urine, even once.
Frequent urination, urinary tract infections, or kidney stones.
Swelling in ankles or around the eyes.
Unexplained fatigue or nausea.
A family history of PKD or unexplained kidney failure.
Even if symptoms are mild, routine screening and imaging (ultrasound, CT, or MRI) can detect cysts early, sometimes years before symptoms appear.
In Dr Anish Kumar Saha, the best nephrologist in Siliguri’s practice, patients with a family history of PKD are encouraged to undergo genetic counselling and periodic kidney evaluations, allowing early planning and prevention.
Tests may include:
Ultrasound scan: The most common and noninvasive way to detect cysts.
CT or MRI: For detailed imaging and monitoring of cyst growth.
Blood tests (creatinine, eGFR): To assess kidney function.
Urine analysis: To check for protein or blood leakage.
Genetic testing: In selective cases to confirm diagnosis and identify risk in family members.
Treatments
While there’s no complete cure for PKD yet, effective management can slow cyst growth, preserve kidney function, and prevent complications. Dr Anish Kumar Saha, the best nephrologist in Siliguri,’s approach is comprehensive, integrating medical therapy, nutrition, and lifestyle changes with cutting-edge monitoring and patient education.
1. Blood Pressure Control:
High blood pressure is both a cause and a consequence of PKD progression.
Dr Anish Kumar Saha, the best nephrologist in Siliguri, prioritizes strict blood pressure management using:
ACE inhibitors (like Enalapril) or ARBs (like Losartan): These not only lower pressure but also protect kidney filters.
Regular BP monitoring: Maintaining levels around 120–130/80 mmHg helps preserve kidney health.
Effective blood pressure control slows cyst expansion and delays kidney failure onset.
2. Cyst Growth Management:
A major advancement in PKD treatment is the use of Tolvaptan, a vasopressin receptor blocker that can slow cyst growth and preserve kidney function in patients with rapidly progressive ADPKD.
Dr Anish Kumar Saha, the best nephrologist in Siliguri, carefully assesses eligibility for Tolvaptan therapy based on kidney size, function, and disease progression. Because this medication requires regular liver function monitoring, he ensures ongoing follow-up and safety evaluations.
3. Pain and Symptom Management:
PKD-related pain is often due to enlarged kidneys, infection, or bleeding cysts. Dr Anish Kumar Saha, the best nephrologist in Siliguri’s symptom management includes:
Pain relief medications that are kidney-safe.
Antibiotics for infected cysts or recurrent UTIs.
Drainage procedures in rare cases of large, painful cysts.
Hydration and posture modification to ease discomfort.
His focus is always on addressing the underlying cause rather than masking symptoms.
4. Preventing Complications:
Complications such as infections, stones, and aneurysms can arise as PKD advances. Preventive measures include:
Staying well-hydrated to reduce stone formation.
Avoiding caffeine, which may stimulate cyst growth.
Regular urine testing to detect early infection.
Imaging studies to screen for brain aneurysms if there’s a family history or symptoms like severe headaches.
5. Dietary and Lifestyle Adjustments:
Nutrition and lifestyle are powerful tools in PKD management. Dr Anish Kumar Saha, the best nephrologist in Siliguri, provides personalized diet plans that support kidney health while slowing disease progression.
Dietary guidelines include:
Reducing salt (sodium) intake to control blood pressure.
Limiting protein to avoid overloading the kidneys.
Increasing fruit, vegetables, and fiber for balanced nutrition.
Avoiding processed foods and sugary drinks.
Drinking enough water throughout the day to keep urine diluted.
Lifestyle habits to adopt:
Maintain a healthy weight.
Avoid smoking and alcohol.
Manage stress through yoga or mindfulness.
Stay active but avoid high-impact sports that could injure enlarged kidneys.
6. Monitoring and Follow-Up:
PKD requires regular, lifelong follow-up to track cyst growth and kidney function. Dr Anish Kumar Saha, the best nephrologist in Siliguri, creates personalized monitoring schedules involving:
Periodic blood and urine tests.
Imaging scans every 6–12 months to evaluate cyst size.
Reviewing blood pressure and medication tolerance.
Continuous tracking helps identify changes early and adjust treatments before complications set in.
7. Managing Advanced Stages:
If PKD progresses to kidney failure, Dr Anish Kumar Saha, the best nephrologist in Siliguri, ensures a smooth transition to renal replacement therapy, offering:
Hemodialysis or Peritoneal Dialysis for waste removal.
Kidney Transplant Evaluation and Preparation, often before dialysis is required.
His goal is to plan proactively, minimizing emergency interventions and maximizing patient readiness for long-term success.
8. Patient and Family Education:
Because PKD is genetic, education and awareness are vital. Dr Anish Kumar Saha, the best nephrologist in Siliguri, counsels families on:
Genetic inheritance patterns.
Screening recommendations for relatives.
Family planning considerations.
Lifestyle practices to minimize progression risk.
Through compassionate discussions and clear explanations, he helps families turn fear into informed action.