What’s life like with one kidney? Here’s what to expect after kidney removal surgery.
by Claire Gillespie Health Writer
Let’s start with the obvious: No one wants to lose a kidney. But if you’ve got cancer, sometimes, you have no choice. And though it may feel like the end of the world to have to give up an actual organ, we promise it’s just the beginning to your journey back to health. The truth is, you only need one functioning kidney to live a healthy life, and usually your body adapts quickly to single-organ status. To understand what life is like with just one kidney, it helps to go back to the point where two became one. Here’s what typically happens.
Understanding Kidney Surgery
If possible, doctors will try to remove only part of a kidney. But the whole organ may be surgically removed if the tumor is simply too large to avoid complete removal, or if it’s located centrally (where all the blood vessels to the kidney run). Your surgeon may also remove your kidney if the tumor has grown outside the organ, invading the blood vessels or growing inside the renal vein, says S. Adam Ramin, M.D., a board-certified urologist with a sub-specialty in urologic oncology and robotic surgery, and medical director of Urology Cancer Specialists in Los Angeles, California. The exact procedure will vary: In laparoscopic surgery, also known as minimally invasive surgery, a small camera is inserted through a series of incisions in the abdominal wall to guide the removal of the kidney through an incision. In an open nephrectomy, the surgeon makes an incision along the abdomen and cuts through blood vessels to remove the kidney.
What Happens Next
After the surgery, you’re likely to have a sore belly for a week or two, but your doctor will give you pain meds for this. Other common side effects are constipation, diarrhea, gas, nausea, or headache. You might get tired more quickly than normal and feel low on energy–it could take a few months to get your energy back. But for most healthy patients who don’t have long-standing hypertension or diabetes, the body adjusts rapidly to the loss of the one kidney within a few weeks, sometimes even in a matter of days, says Jennifer Linehan, M.D., board-certified urologist, urologic oncologist, and associate professor of urology and urologic oncology at the John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California.
All in all, it’s actually pretty amazing how quickly the body adapts to a missing organ. “When one kidney is removed, the other grows large to meet the demand on the remaining kidney to filter and clean the blood,” Dr. Ramin explains. During this process (called concentric hypertrophy), the remaining kidney will grow about 20% to 30% larger. Don’t worry—you won’t feel it, but doctors can observe this via radiographic evaluations, such as ultrasound, MRI, or CT scan.
What Your Blood Work Means
One way that doctors will know how well the body is adjusting is to monitor the patient’s blood work closely, paying particular attention to something called the glomerular filtration rate (GFR), which reveals how well your kidneys are working, plus your creatinine level. We all have creatinine—a waste product resulting from the normal wear and tear on the body’s muscles—in our bloodstream, but a high serum creatinine level generally means the kidneys aren’t working well.
“Typically, there is a bump in the creatinine level after surgery, but it will come down as the body adapts,” Dr. Linehan explains. Normally, depending on your muscle mass, creatinine levels are between 0.5 and 1.2. “When it starts to rise over 2.0, we will try to optimize the kidney function with diet and restrict certain medications like aspirin and ibuprofen, as these can reduce blood flow to the kidney,” Dr. Linehan says.
Beyond creatinine, blood tests after surgery are a good way for your doctor to monitor this like salt and other electrolytes. “We recommend that patients get periodic blood tests looking at the electrolytes, creatinine, and haemoglobin,” says Dr. Ramin. “We may also restrict a patient’s salt and protein intake, in case they are experiencing a small amount of kidney ‘insufficiency.’” (That’s code for your solo kidney isn’t yet up to speed.)
To keep your remaining kidney in tip-top condition, Dr. Ramin recommends the following:
Follow up with your doctor for exams and testing. Testing may sometimes show decreased renal function, which requires treatment.
If you have hypertension, make sure you take your meds as directed by your doctor. Ask your physician if you need to change the class of hypertensive medication you take to one that is more renal-friendly.
Drink at least five eight-ounce cups of water per day.
Be extra careful and vigilant with doing activities that may cause injury to the remaining organ, such as skiing or contact sports.
Reduce your salt intake.
Try to refrain from taking anti-inflammatory medications, like ibuprofen.
Refrain from heavy drinking.
Reduce your consumption of processed foods, which can contain high levels of salt.
Take calcium and vitamin D3 supplements.
Remember, while losing a kidney is nothing to take lightly, in many, many cases, people make full recoveries from kidney removal surgery, to the point that a few months later, they forget they’re even missing one!