Pain Management in Autosomal Dominant Polycystic Kidney Disease

作者：Abdul Hamid Borghol, Fadi George Munairdjy Debeh, Ahmad Ghanem, Mikhail D. Antoun, Vineetha Rangarajan, Jonathan Mina, Mohamed Hassanein, Lyle W. Baker, Sahil Gupta, Shennen A. Mao, Christine Hunt, Marie C. Hogan, Michael A. Mao, Fouad T. Chebib · 发表于：Kidney360 · 年份：2025 · DOI：10.34067/kid.0000000907 · 被引用次数：2 · 研究领域：Genetic and Kidney Cyst Diseases、Biomedical Research and Pathophysiology、Glycogen Storage Diseases and Myoclonus

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disorder. It is primarily caused by pathogenic variants in the PKD1 or PKD2 genes. This leads to the development of numerous kidney cysts, which can result in kidney enlargement and progression to kidney failure. Pain is a common symptom in ADPKD and can negatively affect quality of life (QOL). This pain is often due to the continuous growth of kidney and liver cysts or associated cystic complications. We present a case of a 29-year-old woman with ADPKD who experienced chronic, refractory right-sided flank pain that significantly affected her QOL. Her pain persisted despite taking daily multimodal analgesics and undergoing multiple invasive interventions. She had an unusual asymmetric disease with the right kidney accounting for only 24% of her kidney function. After exhausting all other pain control strategies, she underwent right nephrectomy and partial hepatectomy, which led to substantial improvement in pain and QOL. This review describes the causes, manifestations, and management strategies for abdominal and/or flank pain in ADPKD, including a practical stepwise algorithm to guide clinicians in managing pain and improve QOL of patients with ADPKD. Pain in ADPKD can either be acute or chronic and can lead to significant physical and psychologic distress. Effective pain management in ADPKD requires a multidisciplinary approach, incorporating both nonpharmacologic and pharmacologic interv...