Solitary Kidney

  • When an individual has only one kidney instead of two, this kidney is called a solitary kidney.

    • Why do I have a single kidney?
    • The causes of a solitary kidney may origin from birth or at a later stage:
    • • Some causes are congenital, e.g. people with kidney agenesis are born with only one kidney, or dysplasia, resulting in the inappropriate development of a smaller in size and usually non-functional kidney during endometrial life.
    • • There also acquired causes such as:
    • - nephrectomy (surgical removal of a kidney) due to injury, cancer, or to treat cancer etc.
    • - kidney donation.
    • Is it common to be born with one kidney?

    The exact frequency of agenesis is not specified. Studies indicate a rate of 1 in 1000-1200 live births. Moreover, it is more common in males andoccurs more frequently on the left kidney.

    • What if I was born with only one "working" kidney?

    If you were born with a single kidney or if it was removed at an early age, the other one increases in size. This increase in size is called anticorrosion hypertrophy, and its dimensions can reach about twice the size of a "normal" kidney, resulting in performing all the functions that the two kidneys would do.

    • Are there any long-term problems for people with a single kidney?
    • Individuals with a single kidney usually lead a normal life without any problems from the remaining kidney. The overall survival of the individual is unaffected, but in the long term, (as far as people that were born or lost a kidney in childhood are concerned) some problems may arise, such as:
    • ▪ a mild loss of the kidney function (a procedure that requires approximately 20-25 years).
    • ▪ appearance of arterial hypertension.
    • ▪ albumin in urine may be present (a substance that is an early indicator that there is kidney dysfunction and begins to show signs of deterioration)
    • Do people with a solitary kidney need to be monitored for kidney damage?
    • You must visit your doctor at least once per year and perform the following tests:
    • - measurement of plasma creatinine for the estimation of Glomerular Filtration Rate (GFR) since as the blood is filtered by the kidney its functionality is determined.
    • - annual urine control to detect the presence of albumin with the use of general urinalysis or for greater accuracy with a 24-hour collection of urine.
    • - frequent control of blood pressure (2-3 times per year).

    Blood pressure should be maintained at 110> - <130/80mmHg. Keeping it within these limits acts as a “protective shield” for the kidneys. When blood pressure exceeds these limits, treatment is recommended.

    • Should I follow a special diet?

    Individuals with a solitary kidney need not follow a special diet. People with impaired renal function (kidney failure) may need to make changes in their diet (due to chronic kidney disease) to slow the progression of kidney this case, restriction of protein intake is recommended.

    • Can I do sports?

    The avoidance of injury is important but especially children must continue to do physical activity. The health benefits of sports are numerous and physical activity is essential in everyone’s life. Care is needed in relation to violent injuries. Participating in some sports may be more likely to injure the kidney. This risk concerns to a large extent parents with children with a solitary kidney, as they are more likely to engage in such sports. The American Academy of Pediatrics recommends an individual assessment concerning sports with violent physical contact and conflict. Protective equipment can reduce the chance of injury to the remaining kidney enough to allow participation in most sports, provided that the equipment remains in place during the activity. It is recommended that some sporting activities (boxing, karate, soccer, etc.) must be avoided in individuals with a solitary kidney.

    • Are there any general guidelines I should follow?
    • Maintain your body generally in a VERY good condition:
    • • Do physical exercise (30 minutes a day).
    • • Drink water depending on your feeling of thirst (there is no need for greater fluid consumption).
    • • Avoid smoking due to a possible damage to the kidney vessels.
    • • Maintain a healthy weight and avoid becoming obese (obesity predisposes to kidney damage).

    • Check blood pressure that can also lead to changes in lifestyle and / or medication.

    Mesogeios Dialysis Centers Group Scientific Team

    • Bibliography
    • 1. National Heart, Lung, and Blood Institute. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Washington, D.C.: U.S. Government Printing Office; 2004. NIH publication 04–5230. Report
    • 2."Diet and Lifestyle Changes - National Kidney Disease Education Program (NKDEP)." National Kidney Disease Education Program (NKDEP). Web. 18 Apr. 2015. 
    • 3."Solitary Kidney." Johns Hopkins Children's Center. Web. 18 Apr. 2015.
    • 4. Yalavarthy R, Parikh CR. Congenital Renal Agenesis: A Review.Saudi J Kidney Dis Transpl[serial online] 2003[cited 2015 Apr 18];14:336-41.
    • 5. Sports and the solitary kidney: What parents of a young child with a solitary kidney should know Karen Psooy, MD, FRCSC Division of Pediatric Urology, Winnipeg Children’s Hospital, Winnipeg, MB

    6. Renal aplasia is the predominant cause of congenital solitary kidneys Kidney International. Volume 61, Issue 5, May 2002, Pages 1840-1844