A Rare Case Scenario! A team of medical experts at KMC Hospital, Dr B R Ambedkar Circle, Mangalore perform surgical removal of 4 kg kidney: A rare case scenario
Mangaluru: Doctors at KMC Hospital, Dr B R Ambedkar Circle, Mangalore have managed to perform a rare case of big kidney surgical removal on a 52-year-old female, Mrs Anuradha Paul (name changed) who was presented with a hugely enlarged abdomen due to both kidneys enlargement which is common in rare disease of autosomal dominant polycystic kidney disease (ADPKD).
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disease that can lead to significant disability when complications develop. In ADPKD, fluid-filled cysts develop most of the time in both kidneys, and these cysts become bigger. It can get infected or can cause bleeding within the cysts. Also, ADPKD can progress to renal failure. The disease can significantly impact the quality of life.
After careful evaluation and planning, keeping her age in mind, a decision was made to remove her kidneys in a staged manner, one kidney at a time starting with the left kidney. The open surgical method was opted for as this is preferred considering the size. The patient underwent surgery uneventfully with excellent coordination between the teams of Urology led by Dr. Sanman Gowda and the team, Dr. Sushanth Kumar from Nephrology and Dr. Madhusudhan Upadya, and a team from the Anaesthesiology department of KMC Hospital, Dr B R Ambedkar Circle Mangalore. The patient has resumed daily life.
Speaking after performing the surgery, Dr. Sanman Gowda, Consultant Urologist, KMC Hospital, Mangalore said, “Features of ADPKD often develop between the ages of 30 and 40 years and can eventually lead to kidney failure. In the past, this type was called adult polycystic kidney disease, but children can also develop the disorder. Only one parent needs to have the disease for it to pass to the children. If one parent has ADPKD, each child has a 50% chance of getting the disease. Both females and males can develop this disease. Although called a disease of the kidneys, it can affect the lungs and liver also.”
Dr. Sushanth Kumar, Consultant Nephrologist, KMC Hospital, Mangalore said, “Mutations in either the PKD1 (16p13) or PKD2 (4q21) gene can cause autosomal dominant polycystic kidney disease; PKD1 gene mutations cause ADPKD type 1, and PKD2 gene mutations cause ADPKD type 2. These genes provide instructions for making proteins whose functions are to transmit chemical signals from outside the cell to the cell’s nucleus. The two proteins work together to promote normal kidney development, organization, and function. Mutations in the PKD1 or PKD2 gene lead to the formation of thousands of cysts, which disrupt the normal functions of the kidneys and other organs.”
Commenting on the success of the treatment, Mr Saghir Siddiqui, Regional Chief Operating Officer, KMC Hospital, Mangalore said, “KMC Hospital, Mangalore is one of the best hospitals in Mangalore which provide access to all the healthcare facilities in the neighbourhood region from Kasargod in Kerala up to Karwar in Uttara Kannada district. However, this case was rare and the key findings can be crucial for many patients, and will help save many lives in the future. In this regard, I congratulate the team of Urologists, Nephrologists, and Anaesthesiology department and the entire team for the intricate diagnosis and treatments provided thus giving a better quality of life for the patient.”
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