Ask the Doctor: Disease Can Raise 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% 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.
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.
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