常染色体显性遗传性多囊肾病(ADPKD)是以肾脏肿大为特征的最常见的遗传性多囊肾病,导致肾衰竭.在印度尼西亚,由于有关ADPKD的报道有限,目前尚不清楚该疾病的确切患病率.这项研究的目的是报告一例患有多种并发症的ADPKD患者。一名54岁的男性出现在Soetomo学术总医院的急诊室,泗水,印度尼西亚,主诉深红色尿液一周。在过去的五年里,腹部逐渐增大,在过去的一个月里变得更加紧张和僵化。患者有疲劳和高血压病史,常规随访。入院时体检显示生命体征正常,腹部评估显示,右上腹部有一个约4厘米大小的硬块。实验室检查提示贫血,白细胞增多,淋巴细胞减少,蛋白尿,血尿,白细胞增多症,血清肌酐和尿素水平升高。腹部超声成像,计算机断层扫描(CT)扫描,磁共振成像(MRI)显示双侧肾脏和肝脏肿大包含多个囊肿,提示多囊肾和肝脏疾病。左肾极中部囊肿破裂,CT扫描发现腹水最少。MRI显示两个肾脏都有多个囊肿,部分充满了血液。患者被诊断为ADPKD,肉眼血尿,急性或慢性肾脏疾病(CKD),尿路感染(UTI),正常变色-正常细胞性贫血,和代谢性酸中毒.饮食控制高热量,高蛋白,和低盐饮食;液体平衡;和其他有症状的药物开始。至关重要的是要意识到与ADPKD快速进展相关的危险因素,以便能够对疾病的预防和管理产生有利的影响。
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary polycystic kidney disease characterized by renal enlargement, resulting in renal failure. In Indonesia, the exact prevalence of ADPKD is unknown due to limited reports on the disease. The aim of this study was to report a case of a patient with ADPKD with multiple complications. A 54-year-old male presented to the emergency room of Dr. Soetomo Academic General Hospital, Surabaya, Indonesia, with a chief complaint of dark-red-colored urine for one week. There was a progressive abdominal enlargement over the past five years, which had become more tense and rigid for the past one month. The patient had a history of fatigue and hypertension with routine follow-up. Physical examination on admission showed normal vital signs, and the abdominal assessment revealed a palpable hard mass approximately 4 cm in size in the right upper abdomen. Laboratory test indicated anemia, leukocytosis, lymphopenia, proteinuria, hematuria, leukocyturia, and elevated serum creatinine and urea levels. Abdominal imaging using ultrasonography, computed tomography (CT) scan, and magnetic resonance imaging (MRI) revealed bilateral kidney and liver enlargement containing multiple cysts, suggesting polycystic kidney and liver disease. There was a ruptured cyst in the middle of the left kidney pole with minimal ascites found in the CT scan. The MRI exhibited the presence of multiple cysts in both kidneys, partially filled with blood. The patient was diagnosed with ADPKD, gross hematuria, acute or chronic kidney disease (CKD), urinary tract infection (UTI), normochromic-normocytic anemia, and metabolic acidosis. Dietary control with high-calorie, high-protein, and low-salt diet; fluid balance; and other symptomatic medications were initiated. It is critical to be aware of risk factors associated with the rapid progression of ADPKD in order to be able to provide a favorable impact on the disease prevention and management.