How Can You Live Without One Of Your Kidneys
This is an excellent question, especially because kidney disease and kidney transplants are so common . Most humans are born with two kidneys as the functional components of what is called the renal system, which also includes two ureters, a bladder and a urethra. The kidneys have many functions, including regulating blood pressure, producing red blood cells, activating vitamin D and producing some glucose. Most evidently, however, the kidneys filter body fluids via the bloodstream to regulate and optimize their amount, composition, pH and osmotic pressure. Excess water, electrolytes, nitrogen and other wastes get excreted as urine. These functions maintain and optimize the “milieu interieur” of the body–the fluids in which our cells live.
Life is incompatible with a lack of kidney function . But unlike the case with most other organs, we are born with an overabundant–or overengineered–kidney capacity. Indeed, a single kidney with only 75 percent of its functional capacity can sustain life very well.
This overengineering supplies us with 1.2 million of the basic functional filtering element, the microscopic nephron, in each kidney. Nephrons are tiny tubes that filter the blood plasma, adjust and then return optimized fluid to the body. Under most conditions, though totaling only a few pounds, the kidneys receive about 20 percent of all the blood pumped from the heart. Each day, about 120 liters of fluid and particles enter into the nephron to be filtered.
Why Do Doctors Prefer Transplants
The reason is simple: People who get transplants generally live longer than those who get dialysis. For example, an adult whoâs 30 and on dialysis might live another 15 years. With a transplant, that number jumps to 30-40 years.
Not only do people who get transplants usually live longer, they also tend to have:
- Better quality of life. They donât spend hours each week getting dialysis, and theyâre more likely to go back to work.
- Fewer limits on their diet
- Fewer long-term health problems from the transplant than people have with dialysis
- More energy
Also, dialysis can take a toll on the body. It can cause problems ranging from anemia, where you have fewer red blood cells, to heart disease.
Do You Have To Have A Stent Inserted After Lithotripsy
I have a huge concern with the stent portion of this. After much research on and off the web, it seems out of all patients that have had a stent inserted post lithotripsy, about 80% to 90% of the time it has resulted in extreme pain and discomfort. To me, it seems like this technology is not yet ready for prime time.
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How Might My Life Change After My Kidney Is Removed
People who have only one kidney after a nephrectomy need ongoing care to monitor kidney function. You will need urinalysis and blood tests at least once a year.
You will also have to stay away from activities that increase your risk of kidney injury. For example, you should avoid high-contact sports such as hockey, football or wrestling.
A note from Cleveland Clinic
During a nephrectomy, surgeons remove all or part of your kidney. Healthcare providers may use nephrectomy to remove a tumor or remove a kidney for donation. While most people are born with two kidneys, you can usually function well with only one. You should be able to return to normal activities about six weeks after surgery. After nephrectomy, youll need follow-up care to keep an eye on the function of your remaining kidney.
Last reviewed by a Cleveland Clinic medical professional on 05/02/2021.
References
Keep Your Kidneys Healthy
Your kidneys arent very bigeach is about the size of your fistbut they do important work. They keep you healthy by maintaining just the right balance of water and other substances inside your body.
Unfortunately, if your kidneys start to malfunction, you might not realize it for a long while. Kidney disease usually doesnt make you feel sick until the problem becomes serious and irreversible. March is National Kidney Month, a perfect time to learn more about how to keep your kidneys healthy and how to catch problems early.
Your kidneys are 2 reddish, bean-shaped organs located on either side of your spine in the middle of your back. Their main job is to filter your blood. Each kidney contains about a million tiny filters that can process around 40 gallons of fluid every dayabout enough to fill a houses hot water heater. When blood passes through the kidney, the filters sift and hold onto the substances your body might need, such as certain nutrients and much of the water. Harmful wastes and extra water and nutrients are routed to the nearby bladder and flushed away as urine.
Your kidneys also produce several hormonesMolecules sent through the bloodstream to signal another part of the body to grow or react a certain way.. These hormones help to control your blood pressure, make red blood cells and activate vitamin D, which keeps your bones strong.
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What Can I Expect When I Go Through Dialysis
It shouldnât hurt. If you have pain during or after treatment, tell your doctor right away. You may have side effects, though. Low blood pressure is common. You could also have nausea, vomiting, dry or itchy skin, muscle cramps, or feel very tired.You can lessen side effects by being careful about what you eat and drink. Your doctor can advise how much fluid, protein, and salt you should have.
Hemodialysis patients are also at an increased risk for infections. Try these tips to stay healthy:
- Check your access site daily for redness, pus, and swelling. If you see any, call your doctor.
- Keep the bandage that covers your catheter clean and dry.
Make sure anyone who helps with your treatment washes their hands before and after with soap and water.
What Is The Difference Between A Laparoscopic And Open Surgery
Surgeons use two different techniques for nephrectomies. A laparoscopic nephrectomy uses a small tool with a camera and a few tiny incisions. In a robotic-assisted laparoscopic case, a surgical robot is controlled by the surgeon to manipulate these small tools. An open nephrectomy uses one large incision. Surgeons view directly inside the body and do not use a camera.
Laparoscopic nephrectomy may lead to shorter hospital stays and quicker recovery times. However, surgeons may use open surgery if laparoscopic surgery is not an option. For example, laparoscopic surgery often requires longer periods under anesthesia. Some people may not respond well to being under anesthesia for long periods. Also, others may have a large kidney tumor for which these minimally-invasive techniques may not be the best choice. In these cases, an open approach could be safer.
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How The Kidneys Work
The kidneys are like the bodys garbage collection and disposal system. Through microscopic units called nephrons, the kidneys remove waste products and extra water from the food a person eats, returning chemicals the body needs back into the bloodstream. The extra water combines with other waste to become urine, which flows through thin tubes called ureters to the bladder, where it stays until it exits through the urethra when someone goes to the bathroom.
The kidneys also produce three important hormones:
- erythropoietin, which stimulates the bone marrow to make red blood cells
- renin, which helps regulate blood pressure and
- the active form of vitamin D, which helps control the calcium balance in the body and maintain healthy bones.
Kidney failure, which is also called renal failure, is when the kidneys slow down or stop properly filtering wastes from the body, which can cause buildups of waste products and toxic substances in the blood. Kidney failure can be acute or chronic .
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How Long Do Kidney Transplants Last
There are a number of factors which affect how long a transplanted kidney lasts.
These include whether or not the kidney came from a living donor, how well the kidney is matched in terms of blood group and tissue type, and the age and overall health of the person receiving the donation.
If you have a kidney transplant that fails, you can usually be put on the waiting list for another transplant. You may need dialysis in the meantime.
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What Are The Risks
The main ones are:
Kidney rejection. Thereâs a chance that the body will reject the donated kidney. Your loved one will take medicine for the rest of their life to prevent this from happening, and newer drugs greatly lower the odds of it.
Side effects from medicine. Like any medicine, the drugs used to prevent transplant rejections can have side effects. They generally work by making your immune system less active, which makes you more likely to get infections and can raise the odds of getting cancer. Other side effects may include acne, bone disease, and high blood pressure.
Surgery. Any surgery, including a kidney transplant, has risks, such as bleeding and infection.
Even with these risks, kidney transplant usually leads to a longer and higher-quality life than dialysis. Most people spend just 3-4 nights in the hospital after a transplant and donât have any major issues with the surgery.
Show Sources
National Institute of Diabetes and Digestive and Kidney Diseases: âKidney Transplant,â âChoosing a Treatment for Kidney Failure.â
National Kidney Foundation: âKidney Transplant,â âDialysis.â
Mayo Clinic: âKidney Transplant.â
Cleveland Clinic: â4 Facts You Need to Know about Kidney Transplants and Dialysis.â
UpToDate: âPatient Education: Dialysis or Kidney Transplantation — Which Is Right for Me? .â
Piedmont Healthcare: âThe Benefits and Risks of Kidney Transplant Versus Dialysis.â
Johns Hopkins: âKidney Transplant.â
What Are The Symptoms Of Kidney Failure
In early stages of kidney disease, many people experience few or no symptoms. Its important to note that chronic kidney disease can still cause damage even though you feel fine.
Chronic kidney disease and kidney failure can cause different symptoms for different people. If your kidneys arent working properly, you may notice one or more of the following signs:
- Fatigue
- Poor appetite or metallic taste of food
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How Can I Help Keep My Kidneys Healthy
The best way to take care of your kidneys is to keep a healthy lifestyle, which includes:
- Make healthy meal choices: Follow a kidney-friendly food plan that is low in salt, fat and sugar and includes lots of fruits and vegetables.
- Be active for at least 30 minutes on most days of the week â this can be anything from walking or riding a bike to swimming or dancing.
- If you have high blood pressure or diabetes, follow your treatment plan to keep your blood pressure or blood sugar within your target range.
- Quit smoking or using tobacco.
- Keep a healthy weight â talk with your doctor about what a healthy weight is for you.
How Do I Prepare For A Kidney Transplant
To get a kidney from an organ donor who has died , you must beplaced on a waiting list of the United Network for Organ Sharing .Extensive testing must be done before you can be placed on the transplantlist.
A transplant team carries out the evaluation process for a kidney. The teamincludes a transplant surgeon, a transplant nephrologist , one or moretransplant nurses, a social worker, and a psychiatrist or psychologist.Other team members may include a dietitian, a chaplain, and/or ananesthesiologist.
The evaluation includes:
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Mental health evaluation. Psychological and social issues involved in organ transplantation, such as stress, financial issues, and support by family and/or significant others are assessed. These issues can greatly affect the outcome of a transplant. The same kind of evaluation is done for a living donor.
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Blood tests. Blood tests are done to help find a good donor match, to check your priority on the donor list, and to help the chances that the donor organ will not be rejected.
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Diagnostic tests. Diagnostic tests may be done to check your kidneys as well as your overall health status. These tests may include X-rays, ultrasound, kidney biopsy, and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram.
The transplant team will weigh all the facts from interviews, your medicalhistory, physical exam, and tests to determine your eligibility for kidneytransplantation.
These steps will happen before the transplant:
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What Happens During A Kidney Transplant
A kidney transplant requires a stay in a hospital. Procedures may varydepending on your condition and your healthcare providers practices.
Generally, a kidney transplant follows this process:
You will remove your clothing and put on a hospital gown.
An intravenous line will be started in your arm or hand. More catheters may be put in your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples. Other sites for catheters include under the collarbone area and the groin blood vessels.
If there is too much hair at the surgical site, it may be shaved off.
A urinary catheter will be inserted into your bladder.
You will be positioned on the operating table, lying on your back.
Kidney transplant surgery will be done while you are asleep under general anesthesia. A tube will be inserted through your mouth into your lungs. The tube will be attached to a ventilator that will breathe for you during the procedure.
The anesthesiologist will closely watch your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
The skin over the surgical site will be cleansed with an antiseptic solution.
The healthcare provider will make a long incision into the lower abdomen on one side. The healthcare provider will visually inspect the donor kidney before implanting it.
The renal artery and vein of the donor kidney will be sewn to the external iliac artery and vein.
The donor ureter will be connected to your bladder.
Why Is Kidney Removal Done
The most common reason to have a nephrectomy is to remove a tumor from the kidney. A kidney tumor may be cancerous or benign .
Some people need a nephrectomy if their kidney is the source of repeat infections or is no longer working. Surgeons also use nephrectomies to remove a healthy kidney for a kidney donation.
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How Low Is Low
A healthy kidney filters wastes from the blood at a rate of 90 milliliters per minute or more. This is known as the glomerular filtration rate, or GFR. With time, many men’s kidneys start to slip, but function must decline quite a lot before you start to really feel the impact. You feel fine up to the point that kidney function is almost gone, which means you can lead a normal life with reduced kidney function.
On the other hand, lack of early warning from symptoms can deny you the chance to slow the slide. Most people don’t start feeling really ill until kidney function is under 10%.
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Whats It Like To Live With One Kidney
Most people have two kidneys, but some only have one. There are three main reasons why this could be:
A person is born with only one kidney.
About one in 750 people is born with only one kidney. The medical term for this condition, which is more common in men than women, is renal agenesis. Usually its the left kidney that is missing. Because it is possible to be healthy with one kidney, some people dont find out they have one missing until its discovered on an X-ray or sonogram.
A kidney has been removed due to health problems.
A nephrectomy the surgical removal of a kidney can be necessary if a kidney has been damaged by cancer or another disease, or injured in an accident.
A person donates a kidney.
Every year, thousands of people donate one of their kidneys to someone in need of a healthy one. The recipient is often a blood relative or someone whos close to the donor, such as a spouse or friend. Approximately 87,000 kidneys from living donors were donated from 1988-2008.
What precautions should people take if they have one kidney?
Much of the advice that applies to living with one kidney goes for everybody: eat right, exercise, sustain a healthy weight, stay hydrated and get regular doctor checkups. However, there are special precautions that should be taken by someone living with a single kidney:
What happens if the kidney starts to fail?
Symptoms of kidney failure include: