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How to best manage polycystic kidney disease?

Q: I am a 30 year old lady. I have been suffering from polycystic kidney disease. Now my uric acid is 10 mg%. What should I do? After taking Zyloric, blood came in urine and my haemoglobin became 6 gm%. Please advise.

A:As you already know that you are suffering from adult onset polycystic kidney disease. This disease is characterised by formation of multiple fluid filled cysts in kidneys and to a variable extent involves spleen, liver, pancreas, lungs, ovaries etc. Kidney cysts can cause predominantly three problems. These include bleeding into cysts, rupture of cysts and stone formation, They all can cause pain. In the long run, the cysts cause kidneys to fail. Most common type of stones in this disease are made up of calcium oxalate or uric acid. Your uric acid level are slightly high which can due to variety of reasons including kidney failure. One of the most effective therapy to prevent stone formation in this condition is using Potassium citrate tabs 1-2 tabs three times a day. Do not take it if you have kidney failure or your potassium is running high. Also, seeing a dietician to consume low uric acid diet will help. I am not sure if Zyloric really caused blood to appear in urine. Since there are many causes in this disease that can cause blood in urine. But I am nearly certain that it could not have caused your haemoglobin to drop all the way down to 6 gm.%. In other words, your haemoglobin could have been low to begin with and just dropped further down. Another possibility is that allopurinol caused depression of your bone marrow and bone marrow stopped producing red cells and this dropped your haemoglobin. Thus, you may need to go back to your doctor for further evaluation. I also suggest that you stop taking Zyloric till further tests are done and your doctor okays it. Since you did not give any history, I am assuming that you do not have any menstrual disorders resulting in excessive bleeding which frequently causes anaemia in your age group. It is unusual for polycystic disease patients to become so severely anaemic unless there are other factors involved.

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