50 - A Cadaver Study: Polycystic Kidney Disease with Polycystic Liver Disease and Its Clinical Implications in Anatomy Education

Poster Board Number: 50
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Abstract Body : Introduction and objectives: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disease and one of the most common causes of end-stage kidney disease in human beings, with an estimated 600,000 – 700,000 cases in the United States alone. It is progressive and incurable, associated with a high risk of cardiovascular complications. We present a novel case of bilateral polycystic kidney disease with liver cysts and inferior vena cava compression in a cadaver study. Methods: Left and right kidneys were exposed, the capsules were removed, and a stent was discovered in the inferior vena cava. Both kidneys were visually examined, dissected, and photographed. Polycystic kidneys and the liver were compared with normal counterparts. Analysis of the patient's brief history showed cardiac bypass, hernia, interstitial pulmonary disease, and death from cardiac arrest; however, due to HIPAA and deidentification of the donor, detailed records were unavailable. Results: Both kidneys were enlarged and contained multiple cysts with intervening normal renal tissue; the left kidney’s cysts were larger in comparison. Renal capsules were partially absent. A stent was previously inserted in the inferior vena cava, indicating a drainage issue in this patient. Multiple cysts were found on the surface of the liver. Discussion: In a gross anatomy lab setting, ADPKD is often encountered in cadavers. It would be beneficial for faculty members to be able to explain the condition to the students, especially with the increasing implementation of system-based health science courses. A typical polycystic kidney disease provides a good learning opportunity for the students to not only visualize gross abnormalities, but also relate this multi-organ-system condition to many disciplines, including genetics, histology, biochemistry, physiology and pathology. Students can compare normal kidneys to abnormal kidneys, validate ultrasound and radiographic imaging, and evaluate the treatments the patient had received in the past. They can better understand the relationship between hypertension and polycystic kidney disease, changes in physiopathology, and the impact of medical procedures on patients. Because the disease is progressive, the students can appreciate why periodic monitoring may be of benefit to patients and relate anatomy of the perirenal region to potential complications when surgical intervention is required. In severe cases, students can understand why kidney transplants are the best therapy. Establishment of these correlations has the potential to not only enhance student knowledge, but also explore possible solutions to delay kidney failure, reduce symptom burden, lessen the risk of cardiovascular complications, and prolong life. Conclusions: Autosomal dominant polycystic kidney disease (ADPKD) is a commonly encountered pathology among medical students in the gross anatomy lab. Using this condition to teach students to understand genetic disease, appreciate its progressive nature, and emphasize the relationships of multiple organ systems involved will broaden students' vision of common diseases and lay the groundwork for future clinical courses.