Keeping a Single Kidney Healthy

Kidneys are one of the most important organs of the human system. Nephrectomy (or surgical removal of a kidney) is sometimes performed as a life-saving procedure to maintain healthy survival. Few indications of nephrectomy are; childhood or adult renal tumors and terminal diseases of kidney (such as polycystic kidney disease).
It is imperative to mention that the removal of one kidney is still compatible with life; however, the risk of complications or adverse outcomes increases. Additionally, in case of any disease or terminal pathology of the single kidney, the risk of imminent death is fairly high unless a renal transplant is performed.
 

What Are The Functions of a Healthy Renal System?

Kidneys perform various functions in the body such as:

• Filtration of the blood to remove waste products and toxins (that are produced as part of the normal metabolic processes)
• Maintenance of normal blood pressure
• Regulation of hormones
• Production of red blood cells etc.

How to keep Your Single kidney Healthy?

In order to maintain a long and disease-free survival, it is highly recommended to follow these simple guidelines

1. See Your Doctor at Regular Intervals For Follow-up:

If you are living with a single kidney, it is imperative to see your primary care professional at regular intervals to ascertain the health of kidney. Here is what doctors recommend:

• Medical Checkup: A comprehensive medical evaluation which includes urine analysis and blood pressure monitoring should be conducted at least once a year.
• Tests For Determining kidney Functions: Blood tests are advised to determine the functions of the single kidney such as BUN (blood urea nitrogen), creatinine and electrolytes. This is mainly because, removal of one kidney increases the burden on the remaining healthy kidney which can aggravate the risk of renal damage. The principle marker of the renal damage is a rise in the serum levels of toxins and waste products.
• Evaluation: The reports of all the necessary tests conducted must be analyzed by a nephrologist, who would then advise appropriate actions to address blood pressure issues or management of diet to reduce the production of protein waste products.

2. Maintain Optimal Hydration:

Individuals who have a single kidney are advised to maintain optimal levels of hydration by increasing the normal daily intake of water. High water consumption allows the renal system to filter the blood and remove the toxins. Consume more water after strenuous workouts or in hot humid weathers.
 

3. Do not Ignore Any Signs of Disease or Infection:

Book an appointment with your primary care provider on urgent basis I f you are observing any signs of urinary tract infection; such as:

• Burning sensation during or after urination
• Painful urination
• Increased frequency of urination

Any delay in seeking medical care can increase the risk of permanent damage to the single kidney.
 

4. Revise Your Prescription Drugs:

 Most drugs and prescription pharmacological agents are metabolized and cleared by the kidneys. It is therefore recommended to avoid/ minimize the intake of drugs to maintain optimal health of your single kidney.  If you have to consume a drug for medical indication, make sure to discuss with your primary care provider. Also, look for drugs that are metabolized by the liver to reduce the burden on the kidney.
 

5. Cautious Use of NSAIDS (Nonsteroidal Anti-Inflammatory Drugs):

NSAIDS are generally available as the OTC (over the counter) medications. This class of drugs include pain killers and fever reducing agents such as aspirin, naproxen etc. Use of NSAIDS is associated with development/ aggravation of nephropathy. Therefore individuals with one kidney should avoid nonsteroidal anti-inflammatory drugs altogether.
 

6. Recreational Activities and Sports:

 Physicians do not recommend vigorous physical activities or active involvement in sports (especially contact sports) to individuals with one kidney. It is observed that most cases of kidney damage are associated with traumatic incidents which include accidents, slipping from a bicycle or sports injuries. Consult with your physician immediately after any accident or trauma to lumbar region.
 

Conditions That May Aggravate The Risk of Injury In Individuals With Single kidney:

These condition or risk factors are associated with an aggravated risk of renal damage.

• Cancer treatments such as radiation therapy, use of chemotherapeutic agents such as methotrexate, cisplatin
• Prescription drugs that are used for the management of GVHD (graft versus host disease)
• Excessive use of antibiotics
• High blood pressure
• Urinary tract infections

 
References:

1. Riccio, E., Esposito, G., Franzone, A., Imbriaco, M., Santangelo, M., & Pisani, A. (2014). Renal Sympathetic‐Nerve Ablation for Uncontrolled Hypertension in a Patient With Single‐Kidney Autosomal Dominant Polycystic Kidney Disease. The Journal of Clinical Hypertension, 16(5), 385-386.
2. Dias, P. H. G. F., Oliveira, G. A., Dias, F. G. F., Gomes, R. D. P. X., Tambara Filho, R., & Fraga, R. D. (2015). Effects of immunosuppression with tacrolimus and mycophenolate mofetil on renal histology and function in single kidney rats submitted to ischemia and reperfusion. Acta Cirurgica Brasileira, 30(2), 127-133.
3. Fliser, D., Laville, M., Covic, A., Fouque, D., Vanholder, R., Juillard, L., & Van Biesen, W. (2012). A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guidelines on acute kidney injury: part 1: definitions, conservative management and contrast-induced nephropathy. Nephrology Dialysis Transplantation, gfs375.