Living with one kidney not a death sentence, say nephrologistsL
Nephrologists have said that being born or living with one kidney does not mean a death sentence, affirming that people with one of these vital body organs could live normal and longer lives.
The physicians explained that those lwith one kidney could enjoy good health by adhering to practices that would not be inimical to the function of the kidney or tamper with it.
The kidneys are a pair of bean-shaped organs that sit just below the rib cage. The organs play an important role by helping to remove waste products from the body, maintain electrolyte levels, and regulate blood pressure.
Renal agenesis is a medical condition where an individual is born with one kidney instead of two, while kidney dysplasia is when a person is born with two kidneys, but only one of them is functional.
Globally, an estimated one in 2,000 babies are born each year with kidney agenesis, a condition where newborns have one or no kidneys. Additionally, between one in 1,000 and one in 4,300 babies are born with kidney dysplasia, a condition where the kidneys do not develop properly during pregnancy. Some even go on to develop complications that leave them no choice but to live with a single kidney, according to onlymyhealth.com
Speaking with PUNCH Healthwise, a Professor of Medicine (Nephrology) at the Lagos State University College of Medicine, Olugbenga Awobusuyi, said people born with one kidney can live a normal life, adding that the condition isn’t a death sentence.
He explained that while they may be prone to kidney diseases, many of those born or living with the conditions can live till old age.
“Being born with a single kidney doesn’t mean a shorter life. Many of them do live reasonable lives till old age,” Awobusuyi, who is the Head of Nephrology and Kidney Transplant, Lagos State University Teaching Hospital, Ikeja, said.He added, “The majority of them do live reasonable life expectancy. However, they are more prone to develop hypertension than people with two kidneys. They are prone to develop kidney failures compared to people born with two kidneys and some of them have some other abnormalities that may not even be related to the kidney per se. They may also be prone to infection – urinary tract infection – especially in childhood. But by and large, if they survive till adulthood, they live a reasonable life.”
According to the professor, there may not be a genetic predisposition to the situation because some are just born with the failure to develop while they are in the womb.
He, however, advised women born or living with the condition to prioritise their health and natal care when they get pregnant, adding that they must be under constant monitoring by appropriate physicians before, during and after the journey.
“Those of them who are women, when they get pregnant, they need to come under care early and not that they would get pregnant and not access natal care. When they get pregnant, the doctor needs to monitor their kidney functions because pregnancy puts a lot of pressure on the kidney,” the expert said.
Also, a consultant paediatric nephrologist at UCH, Ibadan, Dr Debo Ademola, said while some of those born with the conditions may be ill or suffer health-related challenges, others may go through life without being sick.
“There is a spectrum on that. Some people can go through life and be fine, while others with the same condition can have protein in their urine or suffer blood pressure or the kidney itself may stop working and they may need a transplant. Living with one kidney isn’t a death sentence, but if there are other conditions to it, we may need to treat or address those issues separately.”
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He listed some abnormalities that may be associated with the conditions, adding that renal agenesis does not also affect the quality of life of some others living with it.
Ademola said, “Part of what is essential is for the patient and physician involved to thoroughly check if there are other abnormalities with the one kidney. Some of the possible abnormalities are that sometimes, some people may have problems with their chromosomes, so you’d find out that a child born with one kidney has Down syndrome and Down syndrome is the condition in which a baby has an extra chromosome more than the usual, so such children may be slow in developing, walking among others.
“Others also include the urogenital system, especially for a girl child to ensure if the vagina is formed properly or are there other issues in that place. Sometimes, the pipe that is taking urine from that kidney may be violated and they have abnormalities in other parts of the body that may have not been formed properly. But sometimes, many of those children may not have any abnormalities.”
Sharing his experience caring for children born with one kidney, the pediatric nephrologist said apart from those with the condition, some children are born with their kidneys located somewhere else in their body.
“I have looked after children with one kidney. We also have children who have other abnormalities of the kidney. I have cared for children whose kidneys are located somewhere else. A lot depends on the other issues the child has. So, we attend to them based on their peculiar cases and needs. The experience depends on other associated features with the one kidney the patient has. The thing that can help us with children with one kidney is to ensure early diagnosis, ensure the necessary checks of their blood pressure and other things they need to monitor,” the expert said.
On conditions that may lead to a child born with two kidneys having only one functioning, Ademola said, “It may depend on the earlier mentioned abnormalities such that over time, the abnormality affects one of the kidneys and it stops working. Sometimes, it may be that something blocks one of the kidneys; an example is that maybe the person has a tumor from another condition and it grows around where the kidney is and presses it, such that it can damage the kidney. There are other conditions too like tumors in the kidney or kidney stones and numerous other conditions can affect just one of the kidneys.”
How they can live longer, healthier lives
He, however, urged people living with the conditions to regularly check their blood pressure, and conduct urine and blood tests to ascertain the state of the kidney and its functions.
“The general advice is that they should avoid drugs that can damage the kidney, especially the pain relief drugs (non-steroidal anti-inflammatory drugs) ibuprofen, diclofenac and others in that category. Essentially, it has been found that many people abuse drugs that are used for pain relief and people with one kidney should avoid such, particularly drugs that could damage the kidney.
“Secondly, they should not take too much salt and other things that are predisposed to hypertension. Also, excessive fats in their diet may expose them to hazards. They should also be careful about the type of sports they engage in. While they need to exercise, it should be moderate and balanced because of their condition. So, those are the general lifestyle changes they can adopt.”
On his part, Awobusuyi said, “A lot of general measures would help them. For instance, they should try to avoid taking too much salt, which is also one of the risk factors for hypertension. If you take a lot of salt, you’re prone to developing hypertension. Being born with one kidney means the patient may not be able to handle a lot of salt in their system compared to someone with both kidneys.
“They should also avoid smoking and being fat. Adding too much weight may put a lot of pressure on the kidney. They should avoid taking substances and native drugs that have been known to be notorious to the kidney.”