nephrectomy advice

[Tulum]

Hi I’m looking for any advice, info or reflections to help with my decision making.

I am 63 and have stage 3a CKD. After a rapid drop in eGfr a couple of years ago a combination of medication and watching my diet has kept my level steady and protein leakage is not increasing (to best of my knowledge) At last nephrology appt in Aug eGfr was 58

I also have a small Bosniak 4 cyst on my right kidney which is likely to be malignant. It was found 2 year ago and until this year had not increased in size. Because it’s now growing I had a nuclear scan a few weeks ago. As a result of the scan consultant recommended that the cyst needs to be removed before it gets any bigger and potentially spreads. I fully understand that. However he also said that my right kidney is my more efficient kidney and performs at 57% while left is 43%. Obviously he shared all the potential risks for my 3 options: radical, partial or freeze the tumour.

My anxiety is related to whether a nephrectomy will have a big detrimental effect on my remaining kidney function. Does anyone have experience of similar situation? I am meeting with surgeon on Weds to further discuss my options and I want to be able to ask the pertinent questions so that I feel as confident as possible in decision I make.

Apologies for long post and thank you for taking the time to read it x

[userotc]

Before my 68y/o mum's nephrectomy (tumour) 6y ago, her eGFR was 60 then 36 afterwards. The nephrologist said he would be happy if it stabilised at that level (but he is a surgeon!). My dad told him we wouldn't!

By adopting solely a Nutritional Therapy protocol, her eGFR steadily increased back to ~60. Not sure which medication you've credited to your stability but mum has had none. We believe nutrition and lifestyle are the answers for ckd.

[Pontios]

Hi Tulum, you have a serious decision to make.Please be aware that if you have CKD lost kidney function there is no scientifically proven way to recover kidney function. The best you can do is to stabilise it or slow down loss progression. If you have AKI then kidney function recovery could be possible.

I do not doubt that the increase in GFR mentioned in the first reply occured however if you have CKD there is no proven way to increase GFR, even with nutritional therapy.

[Bassetmommer NKF Ambassador]

Scary as that is, you do not want to have the malignancy spread. So go with the least evasive surgery, like the freeze. Then keep to a strong renal diet, drink your water, exercise and see how it goes. Many people have managed to stay or slow the progression with diet and healthy lifestyle. I stayed off dialysis for many years with a healthy lifestyle.

[hope1419]

Hi Tulum, I had a nephrectomy because I had kidney stones that couldn't be removed and could cause i fectio. After transplant. Things worked out well. Also, every living donor gets a nephrectomy. The way it was explained to me is that the other kidney grows and takes over the function that both kidneys used to do. However, cancer is serious. I would be scared of just freezing it. I would at least go for a partial nephrectomy. I would trust my doctor's recommendation.