I donated a kidney on May 4, and all went very well, and the Post Op evaluation was May 13, and the surgeon said everything was great and the numbers were where they should be. My GFR went from about 70+ before donating to 39 after surgery! I guess it is to be expected, but I just wasn't expecting this result, even though it does make sense. Does anyone have any thoughts as to what I can expect my GFR will climb to as the months and years go by? Is it true that the remaining kidney grows to about 1.5 times the original size? And, the creatinine level for me is now about 1.75, which is high also. Will this get lower, or is this to be expected? Thanks for any info you have....this is a great place for a lot of people.
Donor's GFR after surgery....what to expect - Kidney Transplant
Donor's GFR after surgery....what to expect
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FixitJosh
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Hey, Josh--My husband gave me a kidney 3 years ago and he's doing great. All his numbers are back to normal ranges. Give it a little time. Yes, he was told the remaining kidney would grow and take up the slack and that seems to be the case for him.
Hi Josh,
Yes, don't worry, the transplant team would have told you if this is unexpected. That being said, don't hesitate to ask them about it!
I am a future donor, just waiting for my recipient to need mine, and I am also in the medical field. So while I am answering your question, I think it is more important that you go to your transplant team with your concerns:
When a kidney is removed, your kidney function (this is what creatinine and GFR measure= kidney function) goes from 100% to 50%, so it makes sense that your GFR basically got cut in half. The remaining kidney will increase in size, and take over some of the lost function of the other kidney. The transplant stats are that you will end up with 60-70% of your normal kidney function. Remember, too, that these are averages, and for you it may be a little different. That is why donor selection is so picky about your starting GFR... they need to make sure that you can do well and live a normal life with only 60-70% of what you started with. It can take many months, up to a year, for the kidney to grow and compensate. Stay hydrated, and ask your team all of your questions.
What advice do you have for a future donor? Any preparation you did, or questions you wish you had asked?
Cheeseanimal,
Glad to hear you are going into the medical field, and that you are already listening to me...the patient, as it were. That would be my biggest advice to you.....listen to the patient, let them ask questions, be patient....things may seem like common place to you as a doctor, but they are all new to a patient like me experiencing first time what it going to be like as a donor. Also, due to You Tube, chat rooms like this one, and more, the average Joe knows a whole lot more these days than in years back, where we only knew what our doctor's told us. For example, I have read many, many books on nutrition, including keto, fasting, metabolic diseases, etc. and watched a lot of You Tubes.....terrific information. So, don't assume your patients are ignorant on many health issues....they could be more informed than you, depending on your field. Honestly, we were given a nutrition guide in the hospital as to foods to eat and not eat, and I could not believe the outdated information they gave us.....
One more thing....dont be afraid to touch people, if they seem receptive to it. My surgeon put his hand on my leg on his first visit the afternoon of the surgery and squeezed it, as he smiled and said how well things had gone, and that really meant a lot to me. He came in both days to see me in the hospital, as well as meeting me personally for the Post Op exam....shook my hand, knew me by name and my recipient as well....he cared. That goes a long way! Hope this helps, and the best to you.
I am also a physician and I agree with Cheeseanimal. My Cr went from 1 to 1.8 and now, six months postop, seems to live at 1.3. I have a solitary kidney patient in the hospital now with a Cr of 0.6. Go figure. I think the normal quoted function is 65% of your preop function, depends a little on age. Younger patients tend to get more function back after donation.
Philly57, do you know what your GFR is now.....I think it has been about 6 months out for you?
I need to check again. My last Cr was 1.26 on 1/11/21 with eGFR of 63, That was only 6 weeks postop. I'll have to stop by LabCorp today. I'll let you know what my eGFR is now.
Hi, having a GFR of 63 is very encouraging to me. Glad it's working out for you. My GFR hopefully will improve the same as you. From what I understand the kidney grows another 50% maybe more. Not sure how long that takes, but I would assume at least a year or two. My recipientsGFR is around 50 now, so that is good and we are hoping that his improves as well. I guess I have to learn to be patient. Thanks for the input and response. Please keep in touch.
So, got results back. A little disappointed. Cr up to 1.38 and eGFR down to 59. No protein in urine, but some hyaline casts, which can be an early sign of kidney issues although strenuous exercise could impact.
Sorry to hear about your results.....although not too bad, just that you were expecting them to go the other way. I guess they can change still. I think they body really needs a whole year to fully get back to normal....so, keep up the exercises and good nutrition and things will most likely get better. I have been adding a little extra protein to my diet to help with tissue repair....hope that helps.
There is relatively recent data on limiting animal protein in your diet. All animal protein, including seafood, causes hyperfiltration which is damaging to kidneys. Some nephrologists are starting to recommend vegan diets for solitary kidney patients (I've included links below). Vegetable protein sources do not cause this problem. Angiotensin receptor blockers (ARBs) tend to inhibit the hyper-filtration effects of animal proteins. So it might be good to start a low-dose ARB even if you don't have hypertension, especially if you want to continue eating animal protein.
kireports.org/article/S2468...
pace-cme.org/2020/01/14/hig....
No doctor is going to recommend taking ARBs for someone with no hypertension purely for the reason of eating meat. Just like.all chemicals, medication comes with side effects.
I do have to agree. I do not take any medications for anything, and have never for 99% of my lifetime, so I am not apt to start now without a very good reason. That said, when I got home from the surgery, I did start cooking more kidney beans, pinto beans, lentils, etc. for protein instead of meat and fish, thought I still do have the animal protein at times. I figured with my GFR low now just 3.5 weeks post surgery, that I would try to give the lone kidney a break and do more vegetable protein. I am normally more Keto and low carb, so will have to make some adjustments for a while there. I dont mind the legumes, etc. for protein as long as I still keep the carbs low, eliminate processed foods and sugary things, and grains, which I am very used to doing. I am hoping when i can back to exercising that it will help the kidney to grow as well. Thanks for all the discussion on this topic....I like to learn and am trying to do my best as I navigate through this transition period. Thanks to you all for your suggestions.
Are you under the care of a general nephrologist?
No....never had a need to....my GFR was 72 before surgery, and I am 68yo.
I agree with LisaSnow, you should find a general nephrologist. This was also recommended to me by my NKF kidney donor mentor, as a good idea for general care after donation.
Ok, thanks for that advice. I will consider doing that, as there are several right in my hometown. I am not at 4 weeks past surgery, and everything is great and I feel as if I can do most anything now. But....I will wait the two more weeks as instructed.....dont want to do anything rash!! l will be keeping track of my Cr. level as well as GFR from now on. I have my annual physical check up in October, about 6 months after surgery, so that should be a good time to get comparisons. I have gone to eating less animal protein, more plant based protein, so I think that is good for now at least. I also fast regularly....24-36 hours, intermittent fasting regularly, and then some 7 days fasts every few months....great way to clean out and detox....I always feel great during them also. Thanks for everyone for help on this site, I do appreciate it.
It looks as if the studies you mentioned have to do with "normal" people with two kidneys. Any chance on any studies for solitary kidney people? I too have heard in many places that more protein is not good for kidneys, and vegan sources seem preferable in terms of being easier on the kidney. I thought the a little extra protein right now just to help mend the muscles and get my body back to normal sooner, then reduce them again. My incision is doing great and healing so quickly, and I have no limit of movement or pain at all.,.. the laparoscopic cuts are a little itchy at night for some reason, but not terrible.
Solitary kidney patients, arguably, should be more strict with diet compared to people with 2 kidneys because we have at best 70% of normal kidney function, which is more taxing on remaining kidney trying to do work of two kidneys. Here is an article specifically about solitary kidney patient management including diet recommendations. sciencedirect.com/science/a...
All of that is to be expected this soon after surgery. Your remaining kidney does grow to accommodate the donated one and your GFR should come back to normal if you give yourself time to heal and continue to hydrate.
Thanks for the info. I am expecting the remaining kidney to grow, and will be anxious to have my GFR checked in October....my 6 month date. Have not started exercising yet....two more weeks to go for my 6 weeks post surgery. Getting anxious to start, but will be safe and go slow for a while. So far, everything is great....I just keep on walking and doing what I can do now.
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