He was 37 years old. A worker working in the farmland. He came to me with a sudden onset of frank blood in the urine with severe pain in the right flank and right lower abdominal area. He vomited a few times, too!
Clinical history and examination findings were suggestive of acute renal colic (stones). Acute appendicitis was a differential diagnosis! However, a urine test was in favor of renal stone too. So, I gave the management for the acute renal stones. I also suggested him doing an ultrasound scanning!
A few hours later he returned with the scanning report. It showed that he is suffering from a genetic condition called adult polycystic kidney disease (Multiple Cysts-like structures in both kidneys replacing the normal working tissues)! It is a progressive disease without any methods to halt the progression. Data shows that the majority of patients with this condition become dialysis-dependent at 52 years of age!! Renal transplantation is the only permanent solution!!
His serum creatinine was still good indicating some viable kidney tissues were still there. His blood pressure was still not high. However, both kidney's sizes were more than the normal range. There were cysts in the liver too!
I suggested him to see a nephrologist ASAP. Continuing dialysis or going for a renal transplant would be a great challenge for him when the time comes. That time will surely come (according to medical data on that disease), maybe within a decade!!
Best wishes for him!
