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2017年2月23日星期四

Coma in Polycystic Kidney Disease


At the late stages of Polycystic Kidney Disease (PKD), patients will tend to be somnolent and even some of them is in coma, even though they have received dialysis. What’s worse, dialysis can lead to coma sometimes. Besides the nerve injury, there are three causes of coma: Renal Failure, bleeding in brain and dialysis disequilibrium syndrome.
1. Renal failure
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Kidney is an organ which is to drain out the metabolic wastes. If the two kidneys fail or are damaged, more wastes will deposit in body, which will elevate blood pressure and disturb electrolyte. At the late stages of PKD, especially uremia, patients will suffer from nervous disorders such as impression and disturbance of consciousness, because of the severe acidosis and heart failure.
2. Bleeding in brain
Cerebral aneurysm is one of the severe complications of Polycystic Kidney Disease. The unstable blood pressure might break the aneurysm. With timely aid after the first breaking, the patient can survive but they may be unconscious or sober alternately. Without mild mood or emotion, the aneurysm can be broken again, which is usually hard to control. The bleeding in brain will make people in coma forever.
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3. Dialysis
Dialysis is a replacement therapy clearing the waste in body, but some people may show coma after dialysis, because the dry weight is set higher than it should be. More fluid or water is removed and the less blood amount can not supply enough blood or oxygen to brain, so coma occurs. Anemia is the common symptom of patients with renal failure in dialysis, which worsens the condition of lacking oxygen in brain. 
When people take dialysis at the first time, dialysis disequilibrium syndrome may occur because they are not acceptable to the dialysers. Before dialysis, the level of waste is very high. When those waste removed suddenly in dialysis, some substances distribute unevenly in blood flow and brain. Brain will have swellings and anoxia. People may feel headache and fell in unconsciousness. However, this coma is usually transient and people will come into themselves later with the urgent aid.
Coma can be caused by aluminuim toxicity during dialysis but it is rare and this toxicity is a long course.
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Coma can result from complex factors with the medical condition of patient. It is important to control blood pressure and emotion for patients with Polycystic Kidney Disease (PKD). At the same time, they should seek for other treatments to delay their diseases deteriorating into Renal Failure and avoid dialysis.

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