Living with a Single Kidney

To have a single kidney is a matter of worry. But with a few precautions and healthy lifestyle the person lives a normal life with a single kidney.

What problems will a person with a single kidney likely face in normal life? Why?

Almost all persons are born with two kidneys. But because of extra capacity and a large reserve, even a single (or solitary) kidney is capable of performing normal functions of both kidneys. So a person with a single kidney does not have any problem in routine or sexual activity or strenuous work.

Only one kidney is enough for a normal and active life for a lifetime. In most of the cases of patients born with just one kidney, the diagnosis of single kidney is made accidentally while performing radiological tests for entirely different reasons.

In a few people with a single kidney over long periods (years), possible ill effects include high blood pressure and loss of protein in the urine. Reduction in kidney function is very rare.

What are the causes of a single kidney?

Three common circumstances in which a person has a single kidney are:

1. A person is born with one kidney.
2. One kidney is removed surgically. Important reasons for removal of one kidney are stone disease, cancer, obstruction, pus collection in the kidney or severe traumatic injury.
3. One kidney is donated for a kidney transplant.

What are the possibilities of having only one kidney from birth?

Many people are born with a single kidney. The likelihood of having only one kidney from birth is about one out of 750 people. A single kidney is more common in males, and it is usually the left kidney which is missing.

Why are precautions required in people with a single kidney?

People with a single kidney function normally, but can be compared with a two wheeler without a spare wheel.

In the absence of a second kidney, if sudden and severe damage occurs to the solitary functioning kidney, acute kidney failure is bound to occur and all kidney functions will worsen rapidly.

Acute kidney failure can cause many problems and complications and needs prompt attention. Within a short period the severity of problems increases and can cause life threatening complications. Such patients need urgent dialysis. To avoid kidney damage and its consequences, precautions should be taken by all people with a single kidney.

In which circumstances is there a risk of sudden damage to a solitary kidney?

Potential circumstances of sudden and severe damage to a solitary kidney are:

1. Sudden blockage to the flow of urine due to a stone or blood clot in the ureter (the tube that connects the kidney to the urinary bladder). The blockage then causes urine to stop flowing out of the kidney.
2. During abdominal surgery, accidental ligation of the ureter of a solitary kidney will prevent the passage of urine to the bladder and will increase pressure in the kidneys that will further damage the solitary kidney.
3. Injury to a solitary kidney. There is a risk of injury to kidney in heavy contact sports such as boxing, hockey, football, martial arts and wrestling. A single kidney becomes larger and heavier than the normal kidney to cope with the requirements of the body. Such an enlarged kidney is more vulnerable to injury.

What precautions are recommended to protect a single kidney?

People with a single kidney need no treatment. But taking precautions is wise to protect the solitary kidney. Important precautions are:

• Drink a lot of water (about three liters per day).
• Avoid injury to the solitary kidney by avoiding contact sports such as boxing, hockey, football, martial arts and wrestling.
• Prevention and early treatment of stone disease and urinary tract infection.
• Before starting any new treatment or abdominal surgery the doctor should be informed that the patient has a single kidney.
• Control of blood pressure, regular exercise, healthy balanced diet and avoidance of pain killers. Avoid high-protein diets and restrict daily salt (sodium) intake if so advised by the doctor.
• Regular medical check ups. The first and most important advice for a person living with one kidney is to have regular medical checkups.

Monitor kidney function by checking blood pressure and testing urine and blood once a year. Regular medical checkups will help detect any early signs of kidney problems or developing kidney failure. Early detection of kidney problems provides opportunity for timely treatment and care.

When should a patient with a single kidney consult a doctor?

Patients with a single kidney should immediately consult a doctor if there is:

• A sudden decrease or total absence of urine output.
• Accidental injury to an enlarged solitary kidney.
• A need to take medicine for pain.
• A need to use X-ray dyes for diagnostic tests.
• Fever, burning urination or red urine.

Source: Kidney Education Foundation