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Friday, August 1, 2014
I m a 54 yr old male. I underwent right nephrolithotomy 25 yrs back. 10 yrs after the surgery the routine investigations revealed non functioning of operated kidney. Now, the size of said kidney has also shrunk. However, the left kidney is perfectely normal in function. Is it necessary to get the non functioning kidney removed? Can it be a source of infection to the left kidney? There are no signs of infection in the nonfunctional kidney as such. Do I need to undergo some special investigations a part from the routine blood and urine investigations?
The nonfunctioning kidney may potentially cause problems in two ways: 1) by getting infected (with infection spreading to the bloodstream or possibly to the other kidney), or 2) by producing a substance called renin that contributes to high blood pressure. Infection can easily be detected by a urinalysis and culture; high renin levels (in the blood) are more complicated to measure, but can be done if needed. As long as your kidney function (as measured by the blood tests BUN and creatinine) is normal, urinalysis is normal, and blood pressure is normal or well-controlled on meds, there should be no need to have the kidney removed. But do be aware that whatever type of stones you had in the right kidney may have a tendency to form in the left as well. So the left kidney should be carefully monitored, probably at least yearly, with urine and blood tests. And of course you should see your doctor immediately if you develop any symptoms of either infection of kidney stones on the left!
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University