Can diet or lifestyle changes help manage kidney cysts?

Question

Hello doctor,

I am a 35-year-old male with a recent history of flank pain and sometimes blood in the urine for several months. There is a strong family history of disease, since my father had polycystic kidney disease. In the recent past, I have noticed swelling of my ankles and fatigue with the slightest effort. My blood test results indicate a creatinine concentration of 1.8 mg/dL (normal range 0.6 - 1.2 mg/dL), and estimated glomerular filtration rate (eGFR) is 55 ml/min/1.73m² which means a slight decline in kidney function. Ultrasound examination found bilateral renal cysts of different sizes, with the largest one measuring 3.5 cm, while some cysts have septation. I have slightly high blood pressure of 150/95 mm Hg despite all lifestyle modifications. Also, there are some episodes of bloating, abdominal discomfort, and proteinuria. My hemoglobin level is 11.2 g/dL, which is below the normal value.

I am afraid of progressive kidney failure, and I want to know: is there anything to slow down the progression of the disease? Do I need to use ACE inhibitors because of my elevated blood pressure? What dietary changes, lifestyle modifications, and/or procedures can be helpful to me?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your worry.

Your findings fit with autosomal dominant polycystic kidney disease (ADPKD), and right now, you are in an early to moderate stage, not kidney failure. Many people live decades before advanced problems develop, especially with good care. Blood pressure control is the most important treatment. Yes, ACE (angiotensin converting enzyme) inhibitors or ARBs (angiotensin receptor blockers) are strongly recommended for you.

These prevent kidney damage, minimize proteinuria, and delay deterioration of renal function. The goal blood pressure level is usually less than 130/80 mm Hg. For slowing disease progression, stay well hydrated (except in case of other advice), lower intake of salt, quit smoking, cut down protein in food, and stop taking NSAIDs (non-steroidal anti-inflammatory drugs). It is necessary to keep ideal weight and do some physical activity regularly. Manage anemia and proteinuria. There are medications available, for instance, Tolvaptan, which slows cysts’ enlargement in certain patients. These need to be discussed with a nephrologist depending on your age, size of kidneys, and speed of their deterioration.

Blood tests and urine tests every three to six months, blood pressure monitoring at home, and kidney imaging every one to two years or as advised. With early treatment and regular care, many patients delay kidney failure for a long time.

I hope this information is helpful to you.

Thanks.