Loaʻa iā ʻoe kekahi mau cysts wai i loko o kou mau puʻupaʻa (Polycystic Kidney Disease)? E kamaʻilio kākou e pili ana i kēia!

Ua lohe paha ʻoe i kahi maʻi kahi e hana ʻia ai nā ʻeke liʻiliʻi i piha i ka wai i loko o nā puʻupaʻa? Loaʻa paha i kekahi o kou ʻohana, a ua lohe paha ʻoe e pili ana iā ia ma kekahi wahi. ʻO kēia ka mea a mākou e kapa nei he Polycystic Kidney Disease (PKD) . He mea weliweli iki paha ka inoa, akā ʻo ka ʻike hou aku e pili ana iā ia hiki ke lilo i mea kūpono. No laila, e kamaʻilio kākou e pili ana iā PKD me nā kikoʻī hou aku i kēia lā.

He aha ka PKD? I ka ʻōlelo maʻalahi...

I ka ʻōlelo maʻalahi, ʻo ka Polycystic Kidney Disease (PKD) kahi kūlana kahi e ulu ai nā cysts i piha i ka wai he nui, e like me nā pehu liʻiliʻi, i loko o kou mau puʻupaʻa . He kūlana genetic ia. ʻO ke ʻano kēia, pono ʻoe e loaʻa kahi gene mutated i loko o kou kino e ulu ai. He ʻokoʻa loa kēia mai nā cysts kidney, ka mea maʻamau e hana ʻia ma kou mau puʻupaʻa wale nō a ʻaʻole ia he mea ʻino.

Hiki i kēia mau cysts i hana ʻia ma muli o PKD ke hoʻonui mālie a hoʻonui i nā puʻupaʻa ʻelua. E noʻonoʻo, i kekahi manawa hiki i kēia mau cysts ke hoʻonui i ke kaumaha o kahi puʻupaʻa i 30 paona (ma kahi o 13.5 kilokani)! A laila, ʻaʻole hiki i ko mākou mau puʻupaʻa ke hana hou i kā lākou hana nui o ka kānana ʻana i nā huahana ʻōpala mai ke koko. I ka hala ʻana o ka manawa, hiki i kēia kūlana ke ulu i ka Maʻi Puʻupaʻa Mau , hiki ke alakaʻi i ka hāʻule ʻana o ka puʻupaʻa . ʻO ka ʻoiaʻiʻo, ʻo PKD ke kumu o kahi 2% o ka hāʻule ʻana o ka puʻupaʻa ma ʻAmelika Hui Pū ʻIa. Pono ka nui o ka poʻe me PKD i ka dialysis a i ʻole kahi hoʻoili puʻupaʻa i kekahi manawa o ko lākou ola.

No laila, inā ʻike ke kauka iā ʻoe me PKD, ʻo ka mea nui loa, ʻaʻole ia e hopohopo akā e hana pū me ia e hoʻomohala i kahi hoʻolālā lapaʻau maikaʻi e hoʻokele i nā pilikia e kū mai ana mai kēia maʻi.

He aha nā ʻano nui o PKD?

ʻElua ʻano nui o ka PKD. E aʻo iki kākou e pili ana iā lākou.

1. ʻO ka maʻi puʻupaʻa polycystic autosomal dominant (ADPKD)

ʻO kēia ke ʻano maʻamau o ka PKD. Hoʻomaopopo pinepine ʻia i ka wā makua, ma waena o 30 a me 50 mau makahiki. Eia nō naʻe, hiki ke ʻike ʻia i kekahi manawa i ka wā kamaliʻi a i ʻole ka wā ʻōpio. No ka hoʻomohala ʻana i kēia ʻano PKD, pono i kekahi o kou mau mākua ke loaʻa ka mutation gene. Loaʻa i ka poʻe me ADPKD kēia mutation i loko o nā genes i kapa ʻia ʻo `PKD1` a i ʻole `PKD2`.

2. ʻO ka maʻi puʻupaʻa polycystic autosomal recessive (ARPKD)

He ʻano laha ʻole kēia. Ua kapa ʻia hoʻi ʻo ia he infantile PKD . Hana ʻia ia i ka wā e noho ana ke pēpē i loko o ka ʻōpū, ʻo ia hoʻi, i ka wā o ka ulu ʻana o ka fetal., ʻaʻole ulu pono nā puʻupaʻa. ʻIke pinepine nā kauka i kēia i ka wā o ka ultrasound prenatal i ka wā hāpai a ma hope paha o ka hānau ʻana o ke pēpē. I mea e loaʻa ai i kahi keiki kēia ʻano ARPKD, pono i nā mākua ʻelua ke ʻano hoʻololi gene i kapa ʻia ʻo `PKHD1`, a pono i ke keiki ke hoʻoilina i ka gene mai iā lāua ʻelua.

Pehea ka maʻamau o ka PKD?

Hōʻike nā helu helu aia ma kahi o 500,000 (500,000) mau maʻi PKD ma ʻAmelika Hui Pū ʻIa wale nō.

ʻO ke ʻano a mākou i kamaʻilio ai ma mua, ʻo ADPKD, ʻoi aku ka maʻamau ma mua o ARPKD. Ma kahi o 90% o ka poʻe me PKD he ADPKD ko lākou. He maʻi laha ʻole ka ARPKD. Hoʻopilikia ia i kahi o hoʻokahi i loko o 25,000 mau kānaka.

He aha nā hōʻailona maʻamau o PKD?

Hiki ke ʻokoʻa nā hōʻailona ma muli o ke ʻano o ka PKD āu e loaʻa ai.

Nā hōʻailona o ADPKD

ʻO ka poʻe me ADPKD, ke ʻano maʻamau, ʻaʻole paha e loaʻa nā hōʻailona a hiki i ko lākou wā makua. I kekahi manawa, ʻaʻole paha e ʻike ʻia nā cysts i hana ʻia i loko o nā puʻupaʻa a hiki i ko lākou nui loa. Inā ʻike ʻia nā hōʻailona, ​​​​hiki iā lākou ke komo pū me:

• ʻEha ma ke kua a i ʻole ka ʻaoʻao (i kapa ʻia hoʻi he "ʻeha ʻaoʻao")
• Ke koko kiʻekiʻe
• ʻEha poʻo pinepine
• Ke koko i loko o ka mimi (Hematuria)
• Nā maʻi ʻōpū mimi pinepine (UTIs)
• Nā pōhaku puʻupaʻa

Nā hōʻailona o ka ARPKD

ʻO nā pēpē me ARPKD, kahi ʻano kakaikahi, hiki ke hōʻike i nā hōʻailona i ka wā hānau a i ʻole i ka wā kamaliʻi. I kekahi manawa, ʻike paha ke kauka i nā cysts i loko o nā puʻupaʻa o ka fetus i ka wā o kahi ultrasound prenatal.

Inā loaʻa i kahi pēpē hānau hou ʻo ARPKD, hiki iā lākou ke ʻike i nā hōʻailona e like me:

• Kaumaha hānau haʻahaʻa
• ʻŌpū pehu
• Loaʻa ke koko kiʻekiʻe i ka wā hānau
• Paʻakikī ka hanu ʻana

Inā loaʻa iā ʻoe ka ARPKD i kou wā kamaliʻi, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Ka hāʻule ʻana o ka ulu ʻana (ua kapa ʻia kēia ʻo "Ka hāʻule ʻana o ka ulu ʻana")
• Nā maʻi ʻōpū mimi pinepine (UTIs)
• Ke koko kiʻekiʻe
• ʻEha ma ka ʻōpū a i ʻole ke kua i lalo

Inā loaʻa ka ARPKD i loko o ka fetus, hiki i nā scans ke hōʻike i kēia mau mea:

• ʻOi aku ka nui ma mua o nā puʻupaʻa maʻamau
• Haʻahaʻa ka pae wai amniotic

Ke ʻike koke mau nei nā hōʻailona o PKD?

ʻAʻole, ʻaʻole. He malū pinepine kēia maʻi ma ke ʻano lapaʻau, me ka ʻole o nā hōʻailona . ʻO ia hoʻi, hiki i ka maʻi ke ulu i loko o ke kino me ka ʻole o nā hōʻailona waho. E noʻonoʻo, ma kahi o ka hapalua o ka poʻe me kēia maʻi ʻaʻole paha lākou e ʻike ua loaʻa iā lākou i ko lākou ola ʻana. Hoʻomaka pinepine nā hōʻailona ma hope o ka ulu ʻana o kēlā mau pehu wai (cysts).

He aha ke kumu o ka PKD?

E like me kā mākou i ʻōlelo ai ma mua, ʻo ke kumu nui o ka PKD, ʻo ia nā hoʻololi genetic . Ua ʻike ʻoe he like nā genes me nā poloka kūkulu kumu o ko mākou kino. Loaʻa iā mākou kēia mau genes mai ko mākou mau mākua. Hoʻoholo kēia mau genes i ke ʻano o ka ulu ʻana a me ka hana ʻana o ko mākou kino. I kekahi manawa, i ka wā embryonic, hoʻololi ʻia kēia gene a ʻaʻole i kope pono ʻia. Inā loaʻa iā ʻoe kēlā ʻano hoʻololi genetic, hiki ke hoʻoili ʻia i kāu mau keiki. Hoʻomohala pinepine ʻia ka PKD ma kēia ʻano.

Eia nō naʻe, he mea kakaikahi loa, ʻoiai inā ʻaʻole i loaʻa i nā mākua ʻelua kēia gene, hiki i ka maʻi ke ulu ma muli o kahi mutation maʻamau i loko o ka gene.

He aha nā kumu pilikia no kēia maʻi?

No ka mea, he maʻi hoʻoilina ka PKD, ʻo ke kumu nui o ka pilikia no kou ulu ʻana, ʻo ia ka mōʻaukala ʻohana. ʻO ia hoʻi, ua loaʻa i kekahi o kou mau mākua ka maʻi (ʻoi aku hoʻi i ka hihia o ADPKD) a i ʻole he mau mea lawe (i ka hihia o ARPKD) nā mākua ʻelua .

He aha nā pilikia e hiki ke loaʻa mai i ka PKD?

Hiki i ka PKD ke hoʻoulu i nā pilikia olakino koʻikoʻi i nā pākeke a me nā pēpē. I kekahi manawa ʻo ka mea a mākou e ʻike ai he mau hōʻailona o ka PKD hiki ke lilo i mau pilikia. Eia kekahi laʻana:

• Nā pōhaku puʻupaʻa
• Ke koko kiʻekiʻe
• Nā maʻi ʻōpū mimi (UTI)

Eia kekahi, hiki i ka PKD ke hana i nā pilikia koʻikoʻi ʻē aʻe, e like me:

• Ke pohā ʻana o nā kīʻaha koko i loko o ka lolo (i kapa ʻia ʻo "Brain aneurysms")
• ʻO nā pilikia o ke kolona, ​​no ka laʻana, diverticulitis, kahi kūlana kahi e hana ai nā ʻeke liʻiliʻi i loko o ke kolona a lilo i maʻi
• Nā pilikia o ka valve puʻuwai
• Ka hāʻule ʻana o ka puʻupaʻa
• Nā cysts ate a me nā cysts pancreatic
• Ke koko kiʻekiʻe i ka wā hāpai (i kapa ʻia ʻo "Preeclampsia")

Hiki i kēia ke lilo i mea make no nā pēpē me ka ARPKD koʻikoʻi. He mea koʻikoʻi loa ka mahina mua o ke ola no nā pēpē i hānau ʻia me ka ARPKD, no ka mea hiki iā lākou ke loaʻa i ka pilikia hanu koʻikoʻi a me ka hāʻule ʻana o nā puʻupaʻa i loko o ia manawa.

Pehea e ʻike ʻia ai ka PKD?

ʻO ka nephrologist (he kauka loea i nā maʻi puʻupaʻa) ka mea maʻamau e hana i ke kuleana nui i ka ʻike ʻana a me ka mālama ʻana i ka PKD. E nānā pono ʻo ia i kāu mau hōʻailona a me ka mōʻaukala ʻohana, a e kauoha paha i nā hoʻokolohua kiʻi e nānā i kou mau puʻupaʻa, e like me:

• ʻO ke ultrasound o nā puʻupaʻa: ʻO kēia ke ʻano i hoʻohana pinepine ʻia, ʻaʻohe ʻeha.
• ʻO ka ultrasound prenatal: Kōkua kēia i ka ʻike inā he PKD ka pēpē i loko o ka ʻōpū.
• CT scan (computed tomography scan): Hiki i kēia ke hāʻawi i nā kiʻi maopopo aʻe o nā puʻupaʻa a me ka ʻōpū mimi.
• MRI (magnetic resonance imaging): Kōkua pū kēia i ka loaʻa ʻana o nā kiʻi kikoʻī o nā puʻupaʻa.

Eia kekahi, ʻo ke kaukaHiki ke ʻōlelo ʻia hoʻi ka hoʻāʻo ʻana i ka genetics. Hiki i kēia hoʻāʻo ke nānā i ke alo o ka gene mutated e hoʻoulu ai i ka PKD i loko o kahi hāpana koko a i ʻole ka lawai. Hiki iā ia ke hōʻoia i ke ʻano o ka PKD āu e loaʻa ai.

He aha nā lāʻau lapaʻau no PKD?

ʻO ka ʻoiaʻiʻo, ʻaʻohe lāʻau lapaʻau no ka PKD i kēia manawa. ʻO ke kumu nui o nā lāʻau lapaʻau ka hoʻolohi ʻana i ka holomua o ka maʻi, ka kaohi ʻana i nā hōʻailona, ​​a me ka pale ʻana i nā pilikia. ʻO nā lāʻau lapaʻau nui no ka PKD:

• Ka mālama ʻana i ke koko kiʻekiʻe: ʻO ke koko kiʻekiʻe kahi ʻenemi nui o PKD. No laila e kōkua kāu kauka iā ʻoe e kāohi i kou koko me ka lāʻau lapaʻau, kahi ʻai olakino haʻahaʻa i ka paʻakai, a me ka hoʻoikaika kino. ʻO ka mālama ʻana i kou koko i kahi pae palekana hiki ke hōʻemi i kou pilikia o ka loaʻa ʻana o nā maʻi koʻikoʻi e like me ka maʻi puʻuwai a me ka hahau.
• Kākoʻo hanu: ʻO nā pēpē me ARPKD, nona nā māmā ʻaʻole i hoʻomohala piha ʻia, a pilikia ka hanu ʻana, pono paha ke kākoʻo ʻia e kahi mīkini hanu .
• Dialysis: Inā ua hāʻule kou mau puʻupaʻa a ʻaʻole hiki ke hana hou i kā lākou hana, pono paha ʻoe e hana i ka "Dialysis" (kahi hana o ka hoʻomaʻemaʻe ʻana i kou koko ma ke ʻano hana). Ma kēia kaʻina hana, kahi mīkini i kapa ʻia ʻo "Hemodialysis" e kānana i kou koko ma waho o kou kino. Ma ka "Peritoneal dialysis" e kānana i kou koko me ka hoʻohana ʻana i kahi wai kūikawā a me kahi membrane i kapa ʻia ʻo ka peritoneum e uhi ana i kou ʻōpū.
• Lapaʻau ulu: Pono paha nā pēpē me ARPKD i kaumaha ʻole a ulu haʻahaʻa ke kōkua i ka ulu ʻana. Hiki i ke kauka ke ʻōlelo i ka lāʻau lapaʻau meaʻai kūikawā a i ʻole ka hormone ulu kanaka .
• Hoʻoili puʻupaʻa: Inā holomua ʻo ADPKD i ka hāʻule ʻana o ka puʻupaʻa , pono paha ʻoe i kahi hoʻoili puʻupaʻa . He hana ʻoki kino ka hoʻoili ʻana kahi e wehe ʻia ai kahi puʻupaʻa hāʻule a hoʻololi ʻia me kahi puʻupaʻa olakino mai kahi mea hāʻawi.
• Hoʻokele ʻeha: Hiki ke hoʻohana ʻia nā lāʻau lapaʻau e hoʻokele i ka ʻeha i hoʻokumu ʻia e nā maʻi, nā pōhaku puʻupaʻa, a i ʻole nā ​​cysts i pohā ma muli o PKD. Eia nō naʻe, ʻo nā lāʻau ʻeha āu e lawe ai, pono ia nā mea i ʻae ʻia e kāu kauka . Hiki i kekahi mau lāʻau ʻeha (ʻoi aku hoʻi nā NSAID) ke hoʻonui i ka hōʻino ʻana o nā puʻupaʻa.

He aha ke kūlana o ke ola o kekahi me PKD?

E makaʻu iki paha ʻoe ke lohe ʻoe i kēia, akā he mea nui e ʻike i ka ʻoiaʻiʻo.

Inā loaʻa i ka poʻe me ADPKD ka lāʻau kūpono, mālama pono i ka maʻi, a hahai i kahi nohona olakino,Hiki iā ʻoe ke ola i kahi ola lōʻihi a piha. Ma kahi o ka hapalua o ka poʻe me ADPKD e loaʻa i ka hāʻule ʻana o ka puʻupaʻa i ka piha ʻana o 70 mau makahiki a pono lākou i ka dialysis a i ʻole kahi hoʻoili puʻupaʻa .

Akā, ʻaʻole maikaʻi loa ka wānana no nā keiki me ARPKD. Ma kahi o ka hapakolu o nā pēpē i hānau ʻia me ARPKD, ʻoiai ka poʻe me nā pilikia hanu koʻikoʻi, make i ka wā kamaliʻi. ʻO nā pēpē e ola pinepine ana e pono ai ka mālama lapaʻau a me ka mālama kūikawā i ko lākou ola ʻana. Ma kahi o ka hapalua o nā keiki e ola ana ma hope o ka wā kamaliʻi e loaʻa i ka hāʻule ʻana o ka puʻupaʻa ma waena o nā makahiki 15 a me 20.

Hiki ke pale ʻia ka PKD?

ʻO ka mea pōʻino, he maʻi hoʻoilina ka PKD, no laila ʻaʻole hiki ke pale loa ʻia . Eia nō naʻe, ma ka hahai ʻana i kahi nohona olakino, ka kaohi ʻana i ke koko, a me ka hahai pono ʻana i nā ʻōlelo aʻoaʻo lapaʻau, hiki iā ʻoe ke hoʻolohi i ka holomua o ka maʻi a hoʻopaneʻe paha i ka ulu ʻana o nā pilikia e like me ka hāʻule ʻana o ka puʻupaʻa.

He mea nui loa i ka poʻe me PKD e hoʻolālā ana e loaʻa nā keiki ke kamaʻilio me kahi kākā'ōlelo genetic i hiki iā lākou ke hoʻomaopopo ʻia e pili ana i ka pilikia o kā lākou mau keiki e hoʻoilina i ka maʻi a me nā hana e hiki ke hana ʻia e pale aku ai.

He aha kaʻu e hana ai e maʻalahi ai ka noho ʻana me PKD?

Hiki ke paʻakikī ke noho me ka PKD, akā ma ka hahai ʻana i kahi nohona olakino a me ka ʻike i ka maʻi, hiki iā ʻoe ke maʻalahi i ka huakaʻi. Eia kekahi mau ʻōlelo aʻoaʻo e kōkua iā ʻoe:

• E ʻai i kahi papaʻai kūpono no nā puʻupaʻa . Pono kēia e kālele i nā meaʻai haʻahaʻa i ka paʻakai, potassium, a me ka phosphorus. E kiʻi i ka ʻōlelo aʻoaʻo kikoʻī mai kāu kauka a i ʻole kekahi meaʻai meaʻai e pili ana i kēia.
• E hana i kahi hoʻoikaika kino e kūpono iā ʻoe, ma ka liʻiliʻi he 30 mau minuke i ka lā, i ka hapa nui o nā lā o ka pule.
• E mālama i ke kaumaha o ke kino olakino.
• E nānā pinepine i kou koko a kāohi iā ia e like me nā kuhikuhi a kāu kauka.
• Inā ʻoe e puhipaka a hoʻohana paha i nā huahana paka ʻē aʻe, e hoʻōki koke.
• E hōʻalo i nā mea inu ʻona i ka hiki.
• E ʻimi i nā ala e hōʻemi ai i ke kaumaha. Hiki i nā mea e like me ka noʻonoʻo ʻana a me ka yoga ke kōkua.
• E inu i ka nui o ka wai a me nā mea inu ʻaʻohe caffeine (e emi ana ke kī, kofe) i ka lā a pau. Eia nō naʻe, inā pono ʻoe e kaupalena i nā wai i kēlā me kēia pae o ka maʻi puʻupaʻa, e hahai i ka ʻōlelo aʻo a kāu kauka.
• E hiamoe maikaʻi ma ka liʻiliʻi he ʻehiku hola i kēlā me kēia pō.
• E lawe i nā lāʻau lapaʻau a pau i kuhikuhi ʻia e kāu kauka me ka pololei, i ka manawa kūpono, a ma ke ʻano i kuhikuhi ʻia. Mai hoʻōki i ka lawe ʻana i kekahi lāʻau lapaʻau me ka ʻole o ke aʻo ʻana a ke kauka.

Āhea ʻoe e ʻike ai i ke kauka e pili ana i ka PKD?

Inā loaʻa iā ʻoe ka PKD, pono ʻoe e noho ma lalo o ka nānā ʻana o ke kauka. Eia nō naʻe, inā loaʻa koke iā ʻoe kekahi o kēia mau hōʻailona , ​​e ʻike koke i ke kauka a i ʻole e hele i ka haukapila :

• Inā pehu koke kou mau wāwae, kuʻekuʻe wāwae, a i ʻole nā ​​wāwae (ua kapa ʻia kēia he edema)
• Inā loaʻa iā ʻoe ka ʻeha nui o ka umauma a i ʻole ka manaʻo o ka paʻa i loko o kou umauma
• Inā pilikia koke ʻoe i ka hanu ʻana
• Inā ʻaʻole hiki iā ʻoe ke mimi
• Inā he nui ke kahe koko me ka mimi
• Inā loaʻa iā ʻoe kahi ʻeha poʻo nui a i ʻole nā ​​​​loli hihiʻo

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

He mea maʻamau ka loaʻa ʻana o nā nīnau he nui e pili ana i kēia maʻi. Mai makaʻu e nīnau i kāu kauka i nā nīnau e like me:

• He aha ke ʻano o ka PKD iaʻu? (ADPKD a i ʻole ARPKD?)
• He aha ka pilikia o ka hoʻoilina ʻana o kaʻu mau keiki i kēia maʻi mai iaʻu aku?
• Pono anei au e hana i kekahi mau hoʻokolohua kūikawā ʻē aʻe?
• He aha ke ʻano lapaʻau kūpono loa iaʻu?
• He aha nā hoʻololi e pono iaʻu e hana i kaʻu papaʻai, ʻoiai hoʻi e pili ana i ka paʻakai, ka potassium, a me ka phosphorus?
• Pono anei au e hana i kekahi mau hoʻololi i koʻu nohona (hoʻoikaika kino, hiamoe, a pēlā aku)?
• Hiki iaʻu ke pono i ka dialysis a i ʻole kahi hoʻoili puʻupaʻa i ka wā e hiki mai ana?
• He aha nā hopena ʻaoʻao a i ʻole nā ​​pilikia e pono iaʻu e makaʻala nui?
• He aha nā hopena ʻaoʻao o nā lāʻau lapaʻau aʻu e lawe ai?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

Ua ʻike ʻoe i kēia manawa ʻo ka Polycystic Kidney Disease (PKD) kahi maʻi genetic e hoʻoulu ai i nā cysts i loko o nā puʻupaʻa. Hiki i kēia mau cysts ke hoʻonui i nā puʻupaʻa a hoʻopilikia i kā lākou hana. Hoʻopilikia pinepine ia i nā pākeke, akā i ka manawa kakaikahi, hiki ke ulu kahi ʻano weliweli o PKD i nā pēpē.

ʻOiai ʻaʻohe lāʻau lapaʻau no ka PKD, mai hopohopo. Ma ka mālama pono ʻana i kāu mau hōʻailona, ​​​​​​e hahai ana i nā ʻōlelo aʻoaʻo a kāu kauka, a me ke ola ʻana i kahi nohona olakino, hiki iā ʻoe ke ola maikaʻi me ke kūlana. ʻO ka mea nui loa, ʻo ia ka hana pū ʻana me kāu kauka a loaʻa nā hoʻokolohua a me nā lāʻau lapaʻau āu e pono ai. ʻAʻole ʻoe hoʻokahi, a aia nā kauka, ʻohana, a me nā hoaaloha e hiki ke kōkua iā ʻoe ma kēia huakaʻi.

ʻO ka maʻi puʻupaʻa Polycystic, PKD, maʻi puʻupaʻa, nā cysts puʻupaʻa, nā maʻi genetic, ADPKD, ARPKD