ADPKD and ESRD: Established Data and Still Open Questions. A Diagnostic-Therapeutic and Qol Upgrade

Abstract

Experiences got from the most recent Literature are reported regarding early diagnosis techniques and targeted and personalized therapies. Main care is focused on the quality of life and psychological support at every stage of the disease. We investigated all the issues regarding women, considering pregnancy as well. The key role of the family support in the management of this chronic and disabling disease is highlighted, beside the crucial help given by the Patient Associations. Peritoneal dialysis is an effective alternative therapy to hemodialysis at the end stage renal failure, even if renal transplantation (single or combined with liver) is still considered the gold standard. It is the optimal solution regarding time and quality of life, management of complications and social cost of replacement therapy. We reported the state of the art about pre-transplantation nephrectomy. A wide debate about indications and timing of surgery still exists. Even if less invasive techniques are now available and spread (pure laparoscopy, hand assisted laparoscopy, minimally invasive open nephrectomy), the most recent data don't support the routine nephrectomy. Surgery should be considered only in case of specific complications and in order to get enough space to perform a safe and low-risk transplantation.