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Washington Health System Nephrology Opens ADPKD Clinic
By Daniel Casciato

Autosomal dominant polycystic kidney disease (ADPKD) is a common, life-altering genetic disease affecting one in every 400 people. In this disease, cysts develop and replace healthy kidney tissues in both kidneys which can lead to kidney failure. Once a person has kidney failure, dialysis or a transplant are the only options.

ADPKD is the fourth leading cause of kidney failure. More than 50 percent of people with ADPKD will develop kidney failure by age 50 according to the PKD Foundation.

“About half of those people who carry this genetic mutation do not necessarily show signs of the disease, but the other half can have fairly significant clinical consequences,” says Dr. Chris Gisler, a nephrologist with Washington Health System Nephrology. “Their kidney function gradually declines and, ultimately, they are at risk of requiring dialysis.”

Symptoms of ADPKD
The average kidney is about the size of your fist. Polycystic kidneys are larger and could weigh up to 30 pounds.

“ADPKD patients develop pain because these cysts are growing and, in some cases, can rupture,” says Dr. Gisler. “Some patients have pain in their abdominal cavity and blood in their urine. It is a disease that progresses over time."

Unfortunately, most patients are asymptomatic at first. Many are never diagnosed with ADPKD because they have few or no symptoms. These are the signs to be aware of:

  • High blood pressure
  • Blood in the urine
  • Pain in the back or abdomen
  • Urinary tract infection
  • Kidney stones

Treating the disease
Dr. Gisler and his colleague, Dr. Shirley Dopson, who both trained extensively to treat ADPKD, recently formed the ADPKD Clinic to help treat patients with this disease.

“Our main goal is keeping patients off dialysis and keeping their kidneys healthy,” says Dr. Gisler. “Patients in Washington and Greene counties were traveling to Pittsburgh or Cleveland to receive specialty care. We wanted to provide them a local option.”

The clinic focuses on pharmacologic and non-pharmacologic therapies. Dr. Gisler and Dr. Dopson will diagnose ADPKD by performing an ultrasound and pay special attention to people with a family history of kidney disease.

“The ultrasound gives us enough information, along with the family history, to make the diagnosis,” says Dr. Gisler.

Earlier this year, a new medication was approved by the FDA— Jynarque. This pill taken twice a day has been shown to slow the growth of cysts and can preserve kidney function. While it doesn’t completely cure ADPKD, it extends the time before a patient needs dialysis or a transplant.

“Patients have access to cutting-edge therapies like Jynarque at our clinic,” says Dr. Gisler. “Additionally, we will counsel and monitor fluid intake because drinking at least 2-to-3 liters of water daily has been shown to slow cyst progression. We will obtain ultrasounds to monitor cyst progression and help patients with genetic counseling such as determining whether family members should be screened.”

If you have a family history of kidney disease, Dr. Gisler recommends getting screened because the sooner you start treating it, the better your outcome.

“Don’t wait until your kidneys are near failing,” he says. “Once your healthy kidney tissue is gone, our options are limited. We want to keep your kidneys healthy and keep you off dialysis.”

For more information or to schedule an appointment call the WHS Nephrology office at (724) 228-1303 or visit whs.org.

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