Q5. Can I live a normal life if I have only one kidney?Most patients with stage I and stage II kidney cancer are likely to receive a nephrectomy, in other cases, one kidney may be donated to a loved one with other kidney disease, such as kidney failure. “Can I live a normal life if I have only one kidney?” is the most concerned question in these cases. Read the following content carefully, you will know almost everything you want to know about living with one kidney.

Renal system is a functional component includes two kidneys, two ureters, a bladder and a urethra. The functions of kidneys include regulating blood pressure, activating vitamin D, producing red blood cells and producing some glucose. Most evidently, kidneys maintain and optimize the milieu interieur (internal environment) of our body by 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.

Unlike the most other organs, we are born with an overabundant – or overengineered – kidney capacity. This overengineering supplies us with more than 1 million of the basic functional filtering element – the microscopic nephron①, in each kidney.

If only one kidney is present, that kidney can adjust to filter as much as two kidneys would normally. In such a situation, the nephrons compensate individually by increasing in size – a process known as hypertrophy – to handle the extra load. This happens with no adverse effects, even over years. Indeed, a single kidney with only 75 percent of its functional capacity can sustain life very well.

In addition to being able to support life with only one kidney, the renal system has other safeguards. Although nephrons stop functioning at a rate of 1 percent per year after 40 years of age, the remaining nephrons tend to enlarge and fully compensate for this demise. Evidence strongly suggests that living kidney donors are highly unlikely to develop significant long-term detrimental effects to their health, as illustrated by donors whose renal function has been assessed for up to 30 years following donation. The main problems with donors are rare instances of complications having to do with the surgery, not the lack of the kidney.

In general, most people with a single normal kidney have few or no problems, particularly in the first few years. However, some longer term problems have been recognized.

If having a single kidney does affect your health, the changes are likely to be so small and happen so slowly that you won’t notice them. Over long periods of time, however, these gradual changes may require specific measures or treatments. Changes that may result from a single kidney include the following:

• High blood pressure.Kidneys help maintain a healthy blood pressure by regulating how much fluid flows through the bloodstream and by making a hormone called renin that works with other hormones to expand or contract blood vessels. Many people who lose or donate a kidney are found to have slightly higher blood pressure after several years.
• Proteinuria. Excessive protein in the urine, a condition known as proteinuria, can be a sign of kidney damage. People are often found to have higher-than-normal levels of protein in their urine after they have lived with one kidney for several years.
• Reduced GFR.The glomerular filtration rate (GFR) shows how efficiently your kidneys are removing wastes from your bloodstream. People have a reduced GFR if they have only one kidney.

You can have high blood pressure, proteinuria, and reduced GFR and still feel fine. As long as these conditions are under control, they will probably not affect your health or longevity. Schedule regular checkups with your doctor to monitor these conditions. Your doctor should monitor your kidney function by checking your blood pressure and testing your urine and blood once a year.

Controlling Blood Pressure

If your blood pressure is above normal, you should work with your doctor to keep it below 130/80. Great care should be taken in selecting blood pressure medicines for patients with one kidney. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are two classes of blood pressure medicine that protect kidney function and reduce proteinuria. But these medicines may be harmful to someone with renal artery stenosis (RAS), which is the narrowing of the arteries that enter the kidneys. Diuretics can help control blood pressure by removing excess fluid in the body. Controlling your blood pressure may require a combination of two or more medicines, and changes in diet and activity level.

Eating Sensibly

Adequate consumption of water is a key aspect of kidney health. In general water helps to maintain the right volume and concentration of blood and other fluids.

Having a single kidney does not mean that you have to follow a special diet. You simply need to make healthy choices, including fruits, vegetables, grains, and low-fat dairy foods. Limit your daily salt (sodium) intake to 2,000 milligrams or less. Reading nutrition labels on packaged foods to learn how much sodium is in one serving and keeping a sodium diary can help.

Avoid high-protein diets. Protein breaks down into the waste materials that the kidneys must remove, so excessive protein puts an extra burden on the kidneys. Eating moderate amounts of protein is still important for proper nutrition. A dietitian can help you find the right amount of protein in your diet.

High-sugar diet increases men’s blood pressure, patients with one kidney should limit consumption of sugar as well.

Limit alcohol and caffeine intake as well.

Avoiding Injury

The single normal kidney will grow faster and get larger than a normally paired kidney. For this reason, the single kidney is larger and heavier than normal, and it is, therefore, more vulnerable to injury. Patients with one kidney should avoid contact sports like boxing, football, and hockey, however one study indicated that motor vehicle collisions and bike riding accidents were more likely than sports injuries to seriously damage the kidneys. Protective gear such as padded vests worn under a uniform can make limited contact sports like basketball or soccer safe. Patients should consider the risks of any activity and decide whether the benefits outweigh those risks.

So yes, you can live a perfectly normal life just like anyone else, follow the rules above and keep a healthier life style and don’t worry too much.

①Nephrons are tiny tubes that filter the blood plasma, adjust and then return optimized fluid to the body.

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