The Future will be different

Guest Post – Dr Andrew Mallett

When I was a fourth year medical student in Townsville I met a man who had ADPKD. Apart from taking his medical history, meeting him sparked for me an interest in renal medicine, physiology and pathophysiology. “What are nephrons? How do they work? Why do they fail?” were just some of the questions that this seemingly straightforward clinical encounter made me ask.

Perhaps more importantly, this patient and I continued to stay in touch and follow up. Even though he was not from Townsville, I would still run into him and his family in the hospital halls and always stop to chat and check in on his progress.

Time moves on and several years later I was a medical registrar in Mackay. There I found myself admitting a patient and saw a lady I instantly recognised. It was the man with ADPKD’s wife. Except now she was his widow. We talked about the intervening years and the condition which had taken so much from their family and her, and whose outcome seemed to feel so helplessly inevitable.

From then onwards, I became fairly set on becoming a nephrologist. Now I am a subspecialist clinician researcher in renal genetics and inherited kidney disease, and the future for many with ADPKD is now changing. An Australian patient support society exists, genetic testing is available and less expensive, coordinated multidisciplinary management is becoming standard of care, prediction models for disease progression are emerging, and effective targeted treatments seem within reach this decade and not the next.

This is an exciting time but most importantly it is the first time that I can say to my patients with ADPKD that the future will be different.




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