Living with One Kidney

Living with one kidney, also known as solitary kidney living, is a situation where an individual has only one functioning kidney either due to a birth defect, surgical removal of a kidney (nephrectomy), or donation of a kidney for transplantation. Despite having just one kidney, most people with this condition can lead normal, healthy lives with proper medical care and lifestyle adjustments.

Living with one kidney requires some extra attention to health and wellness. It’s essential to maintain a healthy lifestyle, including regular exercise, a balanced diet, and staying hydrated. Monitoring blood pressure and kidney function regularly is crucial to detect any potential issues early on.

People with one kidney should also be cautious with certain medications and substances that can potentially harm kidney function, such as non-steroidal anti-inflammatory drugs (NSAIDs) and excessive alcohol consumption. It’s essential to consult with healthcare professionals before taking any new medications or supplements.

Additionally, those with one kidney should be vigilant about protecting their remaining kidney from injury. This includes avoiding contact sports or activities that carry a high risk of kidney trauma.

With proper medical care, lifestyle adjustments, and awareness, many individuals living with one kidney can enjoy full and active lives, often without significant limitations. Regular follow-ups with urologist and adherence to recommended guidelines are key to maintaining kidney health and overall well-being.

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What is “living with one kidney”

“Living with one kidney” refers to the condition where an individual has only one functioning kidney, either because they were born with a single kidney (a congenital condition known as renal agenesis or unilateral renal agenesis) or because one kidney was surgically removed (a procedure called nephrectomy) due to disease, injury, or donation for transplantation. In some cases, a person may be born with two kidneys but lose one later in life due to medical reasons.

Having one kidney means that the individual’s remaining kidney has to perform all the functions that would typically be carried out by two kidneys, such as filtering waste products from the blood, regulating blood pressure, maintaining fluid and electrolyte balance, and producing hormones that help control blood pressure and stimulate red blood cell production.

Living with one kidney usually requires some lifestyle adjustments and regular medical monitoring to ensure the remaining kidney stays healthy and functions optimally. However, many people with one kidney can lead normal, healthy lives with proper care and attention to their kidney health.

Causes

There are several possible causes of living with one kidney:

Congenital Issues: Some individuals are born with only one kidney, a condition known as renal agenesis or unilateral renal agenesis. This occurs during fetal development when one of the kidneys fails to form properly.
Surgical Removal: In some cases, a person may undergo surgical removal (nephrectomy) of one kidney due to various reasons such as kidney disease, kidney cancer, severe trauma to the kidney, or complications from kidney donation for transplantation.
Kidney Donation: Individuals may choose to donate one of their kidneys for transplantation to someone in need of a kidney transplant. This is often done voluntarily to save the life of a family member, friend, or even a stranger.
Injury or Disease: Severe injury or disease affecting one kidney may necessitate its surgical removal to prevent further complications or spread of disease.
Congenital Disorders: Certain congenital disorders or syndromes may be associated with abnormalities in kidney development or function, leading to the presence of a single kidney.
Medical Conditions: Some medical conditions, such as certain types of kidney diseases or infections, may result in the loss of kidney function and require removal of the affected kidney.
Developmental Anomalies: Rarely, developmental anomalies or abnormalities in the formation of the urinary tract during fetal development may result in the presence of a single kidney.

What should people with one kidney pay attention to?

For people living with one kidney, it’s important to take certain precautions and be mindful of their health to ensure the remaining kidney functions optimally. Here are some key considerations:

Regular Medical Check-ups: Schedule regular check-ups with a healthcare provider to monitor kidney function, blood pressure, and overall health. This allows early detection and management of any potential issues.
Maintain a Healthy Lifestyle: Adopting a healthy lifestyle is crucial. This includes eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, and limiting processed foods, salt, and sugar. Regular exercise and maintaining a healthy weight also support kidney health.
Stay Hydrated: Adequate hydration is important for kidney function. Drink plenty of water throughout the day, but be cautious not to overhydrate, especially if there are any restrictions recommended by a healthcare provider.
Monitor Blood Pressure: High blood pressure can strain the kidneys, so it’s essential to monitor blood pressure regularly and take steps to keep it within a healthy range. This may include medication prescribed by a healthcare provider, as well as lifestyle changes.
Be Cautious with Medications: Some medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and certain antibiotics, can be harmful to kidney function. Always consult with a healthcare provider before taking any new medications or supplements.
Avoid Kidney Trauma: Protect the remaining kidney from injury by avoiding contact sports or activities with a high risk of kidney trauma. Use caution when participating in activities that could potentially cause injury to the kidney.
Manage Chronic Conditions: If the individual has any chronic conditions such as diabetes or high cholesterol, it’s important to manage these conditions effectively, as they can impact kidney health.
Avoid Smoking and Excessive Alcohol: Smoking and excessive alcohol consumption can negatively affect kidney function and overall health. Quitting smoking and limiting alcohol intake can help protect the remaining kidney.
Stay Informed: Educate yourself about living with one kidney and stay informed about any updates or recommendations from urologist regarding kidney health.

Follow up

Following up with individuals living with one kidney involves regular monitoring of their kidney function and overall health to ensure early detection and management of any potential issues. Here are some specific aspects of follow-up care for such individuals:

Kidney Function Tests: Regular monitoring of kidney function through blood tests to assess levels of creatinine, blood urea nitrogen (BUN), and other markers of kidney function. This helps to evaluate the remaining kidney’s ability to filter waste products from the blood.
Blood Pressure Monitoring: Regular blood pressure checks are essential, as high blood pressure can strain the kidneys. Individuals with one kidney should aim to keep their blood pressure within a healthy range through lifestyle modifications and, if necessary, medication prescribed by a healthcare provider.
Urinalysis: Periodic urine tests to check for protein, blood, or other abnormalities can provide important insights into kidney health and function.
Imaging Studies: Periodic imaging studies such as ultrasounds or CT scans may be recommended to assess the structure and function of the remaining kidney and detect any abnormalities or complications.
Medication Review: Regular review of medications by a healthcare provider to ensure that any prescribed medications are kidney-friendly and do not pose a risk of harm to the remaining kidney.
Lifestyle Counseling: Ongoing counseling and support regarding lifestyle modifications, including dietary changes, exercise routines, and stress management techniques, to promote overall health and kidney function.
Monitoring for Complications: Individuals with one kidney should be monitored for potential complications such as kidney stones, urinary tract infections, or signs of kidney disease, and appropriate management strategies should be implemented if needed.
Education and Support: Providing education and support to individuals living with one kidney, including information about their condition, lifestyle recommendations, and resources for managing their health effectively.
Long-Term Follow-Up: Regular, long-term follow-up care is essential to ensure continued kidney health and overall well-being. Urologist should establish a schedule for follow-up visits tailored to the individual’s needs and health status.

Possible complications

Living with one kidney may pose certain risks and potential complications, although many individuals can lead healthy lives with proper care. Some of the complications associated with living with one kidney include:

Decreased Kidney Function: Having only one kidney means that the individual’s remaining kidney has to perform all the functions that would typically be carried out by two kidneys. This may result in a decreased overall kidney function, which can lead to a reduced ability to filter waste products from the blood and maintain fluid and electrolyte balance.
High Blood Pressure: Individuals with one kidney may have an increased risk of developing high blood pressure (hypertension) due to the additional strain placed on the remaining kidney. High blood pressure can further damage the kidney and increase the risk of kidney disease.
Proteinuria: Proteinuria, or the presence of excess protein in the urine, may occur in individuals with one kidney. This can be a sign of kidney damage or impaired kidney function.
Electrolyte Imbalance: The remaining kidney may have difficulty maintaining proper electrolyte balance, leading to imbalances in sodium, potassium, calcium, and other electrolytes.
Kidney Stones: Individuals with one kidney may be at a higher risk of developing kidney stones, which are hard deposits of minerals and salts that form in the kidneys. Kidney stones can cause pain and discomfort and may require medical intervention to remove.
Urinary Tract Infections (UTIs): UTIs are more common in individuals with one kidney due to factors such as changes in urinary flow or structural abnormalities in the urinary tract. UTIs can lead to discomfort, pain, and, if left untreated, may progress to more serious kidney infections.
Fluid and Blood Pressure Regulation: The remaining kidney may have difficulty regulating fluid and blood pressure, which can lead to fluid retention, edema (swelling), and fluctuations in blood pressure.
Pregnancy Complications: Pregnancy can pose additional challenges for individuals with one kidney, as the remaining kidney may have to work harder to support the increased demands of pregnancy. There is an increased risk of complications such as pre-eclampsia, gestational hypertension, and impaired kidney function during pregnancy.
Injury to the Remaining Kidney: Individuals with one kidney should take precautions to protect the remaining kidney from injury, as trauma or damage to the kidney can lead to complications and exacerbate existing kidney function issues.

How should people with one kidney eat?

Maintaining a healthy diet is crucial for individuals living with one kidney to support overall health and kidney function. While there isn’t a specific “one-size-fits-all” diet for everyone with one kidney, here are some general dietary recommendations:

Balanced Diet: Focus on consuming a balanced diet that includes a variety of nutrient-rich foods. This should include plenty of fruits, vegetables, whole grains, lean proteins (such as poultry, fish, beans, and tofu), and healthy fats (such as those found in nuts, seeds, and avocados).
Limit Sodium: Reduce sodium intake by avoiding processed and packaged foods, which tend to be high in sodium. Instead, opt for fresh or minimally processed foods and use herbs, spices, and other flavorings to season dishes.
Monitor Protein Intake: While protein is essential for overall health, excessive protein intake can put strain on the kidneys. Aim for a moderate amount of protein in your diet, and choose lean protein sources such as poultry, fish, beans, tofu, and low-fat dairy products.
Stay Hydrated: Adequate hydration is important for kidney function. Drink plenty of water throughout the day to help flush out toxins and waste products from the body. However, be cautious not to overhydrate, especially if there are any restrictions recommended by a healthcare provider.
Limit Phosphorus and Potassium: For individuals with compromised kidney function, it may be necessary to limit intake of foods high in phosphorus and potassium, as these minerals can build up in the bloodstream in kidney disease. Foods high in phosphorus include dairy products, nuts, seeds, and whole grains, while potassium-rich foods include bananas, oranges, tomatoes, and potatoes. Your healthcare provider or a registered dietitian can provide guidance on managing phosphorus and potassium intake.
Control Portions: Pay attention to portion sizes to avoid overeating, which can put excess strain on the remaining kidney. Eating smaller, more frequent meals throughout the day can help regulate blood sugar levels and prevent overloading the kidneys with large amounts of food at once.
Limit Alcohol and Caffeine: Limit alcohol consumption and caffeinated beverages, as these can affect kidney function and blood pressure. Stick to moderate amounts of alcohol, if any, and consider opting for decaffeinated beverages when possible.
Consult with a Dietitian: If you have specific dietary concerns or restrictions due to kidney disease or other health conditions, consider consulting with a registered dietitian who specializes in kidney health. They can provide personalized dietary recommendations and help you develop a meal plan that meets your individual needs and preferences.

Summary

Living with one kidney, whether due to congenital reasons, surgical removal, or donation, requires attention to kidney health and overall well-being. While it may present some risks, many individuals lead healthy lives with proper care. Regular medical check-ups, maintaining a healthy lifestyle including a balanced diet and staying hydrated, monitoring blood pressure, and being cautious with medications are important. Avoiding kidney trauma and staying informed about potential complications are key. With proper management and support, individuals with one kidney can live fulfilling lives.

Prof. Dr. Emin ÖZBEK

Urologist

Istanbul- TURKEY