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Kidney Diseases

Consequences of a Shrinked Kidney?

10/14/2009

Question:

My mom has been recently diagnosed with gall bladder stones. The ultrasound also revealed that her right kidney has shrunk by 4.4*0.9 cm. She has already had a surgery last year for removal of uterus owing to tumor and now this stones surgery is gonna happen within a week. What are the consequences and causes of the shrunk kidney? Is it too serious and dangerous? Her left kidney is perfectly normal and she suffers from high blood pressure and  borderline blood sugar. Will this have long term impact and what is the line of treatment?

Answer:

Whether or not the shrunken kidney has any long-term bad effects depends somewhat on the cause of the shrinking.  Something like this does not happen overnight and is due to some kind of damage that occurred probably years ago.  One possible cause is damage to the artery that supplies the kidney: it can become blocked due to atherosclerosis (hardening of the arteries), which can in turn be caused by high cholesterol, high blood pressure, diabetes, smoking, or some sort of physical trauma.  As the blood supply to the kidney decreases, the kidney shrinks and dies over a period of (usually) years.  Another possible cause is an infection occurring years ago.  When a kidney shrinks, it sometimes produces a hormone that can cause high blood pressure, which can sometimes be quite severe.

In any case, if the left kidney is definitely normal, there should be no problem with her overall kidney function, because people can survive quite well on one kidney, which is why people can be kidney donors for their relatives, for instance.  However, high blood pressure and high blood sugar can both cause kidney damage, so to protect her left kidney, she needs to be sure that she takes her meds, does not smoke, and receives regular medical care.  If her blood pressure is extremely difficult to control, her doctor may want to refer her for studies to determine whether the small kidney is producing renin (the hormone that can cause high blood pressure), and whether the right kidney needs to be removed.

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University