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.