Page 255 - EJMO-9-1

Eurasian Journal of
Medicine and Oncology Quality of life, somatosensory amplification, and stress in ADPKD

in understanding the complex relationship between burdens faced by these individuals, further contributing to
physiological and psychological factors in various health their perceived stress.
conditions. One such condition that has garnered significant The relationship between perceived stress and the
attention is the role of somatosensory amplification in development of CKD has been extensively studied;
PKD. 18,19 PKD is a genetic disorder characterized by the however, the specific impact of perceived stress on the
development of numerous fluid-filled cysts in the kidneys, progression of PKD, a genetic subtype of CKD, remains
leading to progressive kidney damage and eventual an important area of investigation. PKD is characterized
kidney failure. Interestingly, research has suggested that by the formation of multiple cysts within the kidneys,
somatosensory amplification, a phenomenon where resulting in progressive renal damage and, ultimately,
individuals perceive normal sensations as more intense kidney failure. Individuals with PKD often face substantial
or distressing, may play a role in the manifestation and physical and emotional stressors, including chronic pain
progression of symptoms associated with PKD. 20 and concerns regarding their long-term health. Given
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Central sensitization, a process of increased the considerable burden associated with PKD, a deeper
responsiveness and reduced threshold of the central understanding of the role of perceived stress in disease
nervous system to various stimuli, has been identified as a progression and patient outcomes is crucial.
key mechanism underlying somatosensory amplification. Extant research on stress and CKD suggests that
This heightened sensitivity can result in individuals prolonged exposure to stressful life events and high levels of
experiencing pain, discomfort, and other symptoms more perceived stress can adversely impact disease progression
severe than would be expected based on the underlying and worsen clinical outcomes. Specifically, chronic
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physiological changes. Studies in clinical cohorts have stress may contribute to inflammation, hypertension,
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revealed changes in pain sensitivity that have been and other physiological changes that accelerate kidney
interpreted as revealing an important contribution of damage. Furthermore, stress can negatively impact health
central sensitization to the pain phenotype in patients with behaviors, such as medication adherence and dietary
various conditions, including PKD. The comorbidity of management, further exacerbating the course of kidney
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these pain hypersensitivity syndromes, which often present disease. However, the extent to which these findings
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in the absence of inflammation or a neural lesion, and their can be generalized to the PKD population remains
similar pattern of clinical presentation and response to unclear. Several studies have investigated the relationship
centrally acting analgesics, may reflect a commonality of between perceived stress and PKD; however, the findings
central sensitization in their pathophysiology. remain inconclusive, with some studies identifying
Furthermore, the role of central sensitization in PKD significant associations between perceived stress and PKD
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has been explored, with research suggesting that the chronic progression, while others report no such relationship.
pain and other symptoms experienced by individuals Emerging evidence suggests that stress may influence
with this condition may be, at least in part, driven by this disease progression in PKD through various physiological
neuroplastic process. Understanding the potential impact and behavioral mechanisms. Chronic stress can activate the
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of somatosensory amplification and central sensitization hypothalamic-pituitary-adrenal axis and the sympathetic
on the symptom profile of individuals with PKD can have nervous system, resulting in elevated levels of cortisol and
significant implications for the diagnosis, management, catecholamines. These stress-induced hormonal changes
and treatment of this complex condition. may contribute to increased blood pressure and oxidative
stress, both of which are known risk factors for accelerated
1.3. Perceived stress and PKD cyst growth and renal function decline in PKD. In
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Patients with PKD often experience high levels of addition, chronic stress has been associated with systemic
perceived stress due to the chronic and progressive nature inflammation, which may exacerbate renal damage in
of their condition, as well as the significant impact on individuals with PKD.
their physical, psychological, and social well-being. The Behavioral factors also play a critical role in the
uncertainty surrounding disease progression, the need relationship between stress and PKD. Perceived stress can
for lifelong medical care, and the physical symptoms negatively impact health behaviors, such as adherence
associated with the condition, such as pain, fatigue, and to dietary and fluid intake recommendations, physical
episodes of visible blood in urine, can all contribute to activity, and medication compliance. These factors are
elevated stress levels in these patients. The constant fear particularly important in managing PKD symptoms and
of disease progression and the need for ongoing medical slowing disease progression. Furthermore, individuals
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management can exacerbate the psychological and social experiencing high levels of stress may be more prone to

Volume 9 Issue 1 (2025) 247 doi: 10.36922/ejmo.7550