New kidney condition

[memat09]

I am a 77 year old female that recently had my right kidney removed due to cancer. My left kidney activity went from 67 to 30. Not sure what to expect going forward.

[Bassetmommer NKF Ambassador]

Well. You had one kidney removed and your GFR went way down....because you only have one kidney or was it higher before and just recently the one GFR for the ONE kidney went down? Big difference in the situation. You lost one of the filters, which is what GFR measures, and so I would expect a decline. Now if the GFR was up before this and declined, after the surgery, then something else might be going on.

[userotc]

Before a nephrectomy for the same reasons, my mum's eGFR was 60 then dropped to 36. Whilst her nephro was happy with that, we weren't and we managed to get it back to ~60 before falling a bit to a figure reported to be typical for single kidneys (I can send link if you want). A recovery like that is not uncommon as long as you take care of the kidney.

For other details on single/solitary kidneys, check out my recent post on "single-kidneyers".

Let me know if you have any queries or cant find the above post.

[PKDpostTRANSPLANT]

I received a kidney from a live donor. For my donor, she was told that right after the surgery her single kidneys egfr would be lower and then it will grow to compensate for the loss of the second kidney. Her egfr did end up going up to about 60 with one kidney.

So if your nephrectomy just happened that could be the case. But if you needed chemo that can cause kidney damage too (as far as I know) So for your situation it is difficult to say what to expect.

I'm sorry to hear about what you are going through. I hope you can see a nephrologist to monitor what your egfr does going forward. With one kidney, doctors usually say not to take any NSAIDS for pain, eat low sodium and stay hydrated.

[Jwbak]

I had my left kidney removed due to cancer March 2023. Unfortunately there were complications and my remaining kidney went into acute kidney injury. I got to experience diakysis for a couple months.

Before surgery I had a eGFR of 78, a year after surgery I seem to be settling in at 30 eGFR. I attributed the loss to the acute kidney injury. My nephrologist told me they usually expect about a 10% drop in GFR as the other kidney takes over.

You can live with 30. I’m a little more tired than I used to be but I can function.

I had a frank discussion with my nephrologist and he told me the average GFR loss per year is 1 to 2 percent (I assume it depends on your diet). I’m 51, I just have to accept that sometime in my 60’s I will be on dialysis, hopefully not.

The kidney disease world is not a fun one to be thrust into. I hope your kidney does make a recovery and you gain more function.

[userotc in reply to Jwbak]

Did anything in my post 2m ago headed "Call out to Single Kidney-ers resonate with you eg urine albumin? If you can't find via search, I can send

[Jwbak in reply to userotc]

Thanks for checking in. I read your post and it's good to get the information.

I do have some protein in my urine but not too high 254mg/g on my last test, but my GFR is now at 28. All my other numbers seem normal though.

My main concern is that the acute kidney injury did permanent damage and I will probably not recover more function. I'm not sure what to do except watch my diet, exercise, and hope for the best.

[userotc in reply to Jwbak]

Do you mean albumin/creatinine ratio = 254mg/g? If so, it's similar to mum's = 278mg/g or 31.4 mg/mmol and so ~900% over-normal range. But her protein/creatinine ratio is only = 45 mg/mmol so just ~300% over normal and seemingly more stable.

So a key part of the blog is that proteinuria may be a better monitor for mum than albuminuria (and maybe you too if youre also not diabetic?). This at least tallies with her nephro being relaxed with her urine results. He wont explain why the albumin is so much higher but it's the smaller part of urinary protein so that may be a factor. She's now 2mths into the melatonin so 🤞🤞.

We are also monitoring her fast-reducing serum bicarbonate which could be relevant. Do you know how yours is (it can cause reduced function)? Mum's latest eGFR is ~50 ml/min so typical for single-kidneys, as per blog.

Note: My mum's kidney cancer was >7y ago so hopefully that comforts you although she's always anxious at CT scan stage, now bi-annually.

[Jwbak in reply to userotc]

Sorry, not to clear on the different all the different ratios. I am not diabetic.

My Prot/Creat is 254 mg/g, so 28.7 mg/mmol?

I don't see any tests for albumin/creatinine ratio or a straight albumin measurement for my urine. Is this something you usually request.

Fast-reducing serum bicarbonate, never heard of it and it's not in my tests. Again is this something you had to specifically request?

My cancer was slow growing (although it was 7inches in diameter and 4.5 lbs) and somewhat rare. My urologist thinks it's very unlikey to have a reoccurrence. It hadn't metastasized so no chemo. I haven't really thought about it much since, CKD has been my main concern, although I'm just kind of in the acceptance phase now.

I'm not to impressed with my nephrologist. The general attitude seems to be there isn't much we can do so we will just monitor until you are back on dialysis. I haven't had any deep analysis of my numbers, if it's happening it's in the background.

I'm glad your Mom is up to 50eGFR, seems like a good number to be at.

[userotc in reply to Jwbak]

Thanks for responding. Yes I believe serum albumin and also bicarbonate could/should be monitored. And, as you'll note in the post I did on single kidneys, a nice lady named Darlenia (on behalf of her husband) believes many parameters should be monitored with ckd.

That said, mum's nephro pays less attention to her albumin and bicarbonate which is the main source of our frustration with him. So we are also unimpressed with her nephro!

So I think we'd both agree we shouldn't just leave it to nephros to look after us. As per blog, we don't and, like others on this forum, we use natural solutions to help mum's ckd.

Mum always focuses on egfr. Whilst now 50, please note it was 36 after the nephrectomy, gradually increasing to 76 over a few years after adopting a Nutritional therapy/natural protocol. It now seems reasonably stable 🤞

So yours could also increase significantly, whatever your poor nephro says (although mum didn't have a known AKI).

Your tumour was similar to mum's. Hers was 13cm in size, also v slow growing so no other treatment besides the nephrectomy 🙏

Feel free to stay in touch as your respective journeys progress eg via private message.