Polycystic kidney disease raises blood pressure
DEAR DR. DONOHUE: A serious problem confronts my family, and I would appreciate your input. When my husband was in his 30s, the doctor discovered he had high blood pressure. It struck the doctor as odd that someone his age would have such a high pressure. He did many tests and discovered that my husband had polycystic kidney disease. Some years later, he had a kidney transplant. We have an 18-year-old son, and my husband’s doctor wants to check him. The boy refuses. What should we do? — T.C.
ANSWER: Polycystic kidney disease is a genetic illness leading to enlarged, cystic kidneys that often ends in kidney failure and requires a kidney transplant. Different varieties of this condition exist. I’m limiting the discussion to the most common variety, autosomal dominant polycystic kidney disease, ADPDK. “Autosomal dominant” indicates only one gene from either parent passes the illness to their children. The children have a 50 percent chance of developing the illness.
Signs and symptoms don’t usually express themselves until people reach their 30s or older. The first sign is often high blood pressure. Your husband had a sharp doctor who picked up on this.
Ultrasound pictures of the kidneys can detect the illness with reliability. As time passes, kidney function deteriorates, and often the ultimate treatment is a transplant.
Your son’s dilemma isn’t unique. Children of every polycystic patient face the same predicament of deciding whether to learn they have the illness or put off that upsetting experience until later in life. One advantage of early diagnosis is close monitoring of kidney function so interventions can begin when symptoms are just emerging. And there are hints that preventive treatment might halt progression of full-blown illness. Disadvantages include problems with insurance coverage and possible troubles with employment. Most kidney specialists feel children of 18 should be tested.
Your son and your husband would be wise to contact the Polycystic Kidney Disease Foundation, a source of invaluable information. The foundation’s phone number is 800-PKD CURE, and its Web site is www.pkdcure.org.
TO READERS: The booklet on high blood pressure deals with the more common kind of hypertension. Readers can order a copy by writing: Dr. Donohue — No. 104, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: When I was 22, I drove a motorcycle and had a bad accident. My spleen was removed. I am 69 and am healthy. How does not having a spleen affect my health? — B.R.
ANSWER: It hasn’t had much of an impact on your health for 47 years. However, the spleen is one of our defenses against infection. It makes antibodies against germs.
Even though you’ve not had any serious infection for all these years, you must keep your immunizations up to date, and you should get the pneumonia shot. That shot protects you from the pneumococcus (NEW-moe-KOK-us) germ, the germ that causes the most prevalent kind of pneumonia. Without a spleen, people who contract a pneumococcal infection are in great danger of dying from it. The vaccine will give you the protection you need. Everyone over 65 should have this vaccine.
DEAR DR. DONOHUE: You might find this crazy, but I live in constant fear of breast cancer. I am only 19. I check my breasts daily for any lumps, and have done so since my breasts developed. I think I feel a lump. What should my next step be? — K.C.
ANSWER: Breast cancer at your age is unlikely but not impossible. Breast cancer before the mid-30s is most unusual. Having found a lump, you have no alternative other than seeing a doctor. Lumps develop, however, for many reasons other than cancer.
Once you get this matter settled, you have to confront your obsession with breast cancer. It’s healthy to fear cancer. It’s not healthy to dwell on it daily, as you are doing.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.

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