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Urology (Expert Forum)
Will an atrophied kidney resume function?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Will an atrophied kidney resume function?
by John C, Jul 17, 2003 12:00AM
I am 55 years old. Since 1983 I have had over 20 kidney stones, mostly on the left side. Most passed, but several times I had ESWL and other procedures.
Two months ago I was having kidney stones twinges in the left ureter area. I started getting blood in the urine and feeling very uncomfortable. I went to a new urologist on Tuesday. Two days later I passed a 5mm stone, and after a day of recuperating felt fine.
Since I was scheduled for a cystoscopy already I went in for it thinking it would merely confirm I was OK. Well, the doctor advises me I have a medium varicocele on the left side, he cannot get the scope in the left ureter, and I have a 'shadow' in the renal pelvis area CT!!! Four days later I have a nephrosotomy. The radiologist manages to get a stent in past what he believes is a stone, not tumor. He says the shadow was probably a hematoma and actually spun it around 360 degrees with the wire while I was looking at the screen.
Soon after my urologist does a laser uretoscopy and blasts a 1 cm stone in the ureter. The stent is left in. Test show a 1.7 and 1.4 values for creatine, all other blood values are normal. Cytology is negative. The shadow is 'non-remarkable' according the CT reader. By the way, I'm told the left kidney is atrophied.
My urologist is still concerned that I might have cancer and is going to look at it when he removes the stent next week. Also I am scheduled for a renal function test.
I have been reading the internet and naturally have a lot of issues:
1. Assuming the kidney is 'atrophied' does that mean it will be removed?? Why or Why not?
2. With the varicocele, atrophied kidney and 'shadow' should I still be concerned about cancer, even though there are numerous negative reports? Or RAS? My BP last read was 147/74. It has been 120/80 since I retired. About 142 over 90 before I retired.
3. Will an atrophied kidney recover and/or gain function OR is it just gone?
4. Will the ureter, which was distended, recover its shape and function?
5. If I lose the left kidney will I start getting stones in the right kidney? (90% or better have been on the left).
Thanks
Two months ago I was having kidney stones twinges in the left ureter area. I started getting blood in the urine and feeling very uncomfortable. I went to a new urologist on Tuesday. Two days later I passed a 5mm stone, and after a day of recuperating felt fine.
Since I was scheduled for a cystoscopy already I went in for it thinking it would merely confirm I was OK. Well, the doctor advises me I have a medium varicocele on the left side, he cannot get the scope in the left ureter, and I have a 'shadow' in the renal pelvis area CT!!! Four days later I have a nephrosotomy. The radiologist manages to get a stent in past what he believes is a stone, not tumor. He says the shadow was probably a hematoma and actually spun it around 360 degrees with the wire while I was looking at the screen.
Soon after my urologist does a laser uretoscopy and blasts a 1 cm stone in the ureter. The stent is left in. Test show a 1.7 and 1.4 values for creatine, all other blood values are normal. Cytology is negative. The shadow is 'non-remarkable' according the CT reader. By the way, I'm told the left kidney is atrophied.
My urologist is still concerned that I might have cancer and is going to look at it when he removes the stent next week. Also I am scheduled for a renal function test.
I have been reading the internet and naturally have a lot of issues:
1. Assuming the kidney is 'atrophied' does that mean it will be removed?? Why or Why not?
2. With the varicocele, atrophied kidney and 'shadow' should I still be concerned about cancer, even though there are numerous negative reports? Or RAS? My BP last read was 147/74. It has been 120/80 since I retired. About 142 over 90 before I retired.
3. Will an atrophied kidney recover and/or gain function OR is it just gone?
4. Will the ureter, which was distended, recover its shape and function?
5. If I lose the left kidney will I start getting stones in the right kidney? (90% or better have been on the left).
Thanks
Doctor's Answer
by Kevin Pho, MD, Jul 19, 2003 12:00AM
, Jul 19, 2003 12:00AM
Hello - thanks for asking your questions.
1) Because the kidney is atrophied, it doesn't necessarily mean it will be removed. If there is evidence of cancer, then removal may be considered.
2) Without examining you or your studies, this is impossible to answer. You may want to discuss the possibility of MRI or biopsy to further elucidate the lesion. As for renal artery stenosis, this can be evaluated by a captopril renal scan, MRA, ultrasound or angiography.
3) If the kidney has atrophied, it is likely that irreversible damage has occured.
4) Whether the ureter can recover depends on the cause of its distension. I cannot answer this question without reviewing the studies.
5) It is possible - it depends on what kind of stones were formed. You would be at higher than average risk of developing kidney stones in your right kidney.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
1) Because the kidney is atrophied, it doesn't necessarily mean it will be removed. If there is evidence of cancer, then removal may be considered.
2) Without examining you or your studies, this is impossible to answer. You may want to discuss the possibility of MRI or biopsy to further elucidate the lesion. As for renal artery stenosis, this can be evaluated by a captopril renal scan, MRA, ultrasound or angiography.
3) If the kidney has atrophied, it is likely that irreversible damage has occured.
4) Whether the ureter can recover depends on the cause of its distension. I cannot answer this question without reviewing the studies.
5) It is possible - it depends on what kind of stones were formed. You would be at higher than average risk of developing kidney stones in your right kidney.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
