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ADPKD Beyond growth and decline

PhD ceremony:Mr N.F. (Niek) Casteleijn
When:January 11, 2017
Supervisors:prof. dr. R.T. (Ron) Gansevoort, prof. dr. C.A.J.M. Gaillard, prof. dr. G.J. Groen
Co-supervisor:dr. A.M. (Annemarie) Leliveld-Kors
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
ADPKD Beyond growth and decline

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease and is characterized by progressive cyst formation in both kidneys and renal function loss. It is the fourth most common cause of end-stage renal disease for which renal replacement therapy has to be started. Beyond decline of renal function and renal cyst growth, patients may experience other symptoms such as pain, gastrointestinal discomfort and polyuria (large production of urine).

In the first part of this thesis a comprehensive overview of pain in ADPKD is given, and several novel pharmacological approaches and minimally invasive therapeutic options are investigated as potential new therapies for ADPKD-related pain.

In the second part, the symptom polyuria which is caused by an impaired urinary concentrating capacity, is evaluated and discussed, with special attention for its possible consequence for disease progression.

Results of this thesis show that although these symptoms are common in ADPKD patients, they attain little attention by physicians and their consequences thus may be underestimated. The diagnosis of this inherited kidney disease may be an emotional burden, because of the consequences for family and career planning. For these reasons sometimes customized care by physicians or nurses with specific experience in ADPKD is indicated. Also, for regular clinicians it is important to recognize and adequately respond to the emotional, social and symptom burden that ADPKD patients may experience, as the disease can have a negative impact on the patient’s quality of life.