atrophied kidney removal

i was born with a double kidney on one side with reflux in ureters and a small urethra.  This was not discovered until I was 11 so there was much damage to the side with the double kidney, and a little damage to the single one.  I was operated on a 14 to dilate the urethra and had a graft of the ureter to solve the reflux problem.  The extra kidney shrunk away in time and the kidney it was attached to had a function of 20%.  The other kidney grew to compensate for the lack of function of the other side.

Recently I went to my GP to ask about terrible migraines, which I hadn't been suffering from since I had the operation.  My blood pressure was elevated, which I have never suffered from before (I'm now 34).  A 24-hour urine collection was done which indicated high protein levels and an ultrasound was showing that the poorly functioning kidney had atrophied.  My doctor has referred me to a nephrologist and suggested that the atrophied kidney may have to be removed to control the blood pressure.  It will be a while before I see the specialist as he is very busy and I am wondering how much I should be worrying at this point.  How long will it be before my relatively good kidney is damaged?  Is it necessary to remove the dead kidney?  I supose doctors have to be blase about these things so as not to start a panic......nevertheless, I am worried.  Thank you for your time.

[Kevin Pho, MD]

Regarding the time for the good kidney being damaged - that would vary from person to person.  In most cases, people are able to survive with one functioning kidney.  

The prognosis for patients with one normal kidney is excellent, with a survival rate similar to that of age and sex-matched controls from United States life tables. However, proteinuria, hypertension, and renal insufficiency appear to be more common later in life.

The types and frequencies of abnormalities in this population included proteinuria (>150 mg/day, 19 percent), hypertension (47 percent), and decreased renal function (adjusted for age and sex, 13 percent).

Regarding the decision to remove to dead kidney, if the urologists and nephorlogists feel that it is adversely affecting blood pressure as well as the renal function of the other kidney, then consideration may be made to its removal.  

As for needing to remove the atrophied kidney - that is difficult to tell without being involved in your case.  

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.

Bibliography:
Ozcan.  Renal agenesis.  UptoDate, 2004.

[rory4]

A related discussion, removal of kidney was started.