Due to this fact and the lack of cadaveric donors, it is not astonishing that a certain pressure arose to recruit living donors [ 3 ]. Reports that living donation is safe are therefore important and would justify this treatment of choice for our recipients. But is kidney donation really safe for the donor? If it is possible to remove one kidney without long-term harm, why did mother nature give us two? Therefore, the question has to be asked: do the current studies, analyzing the outcome of living donors, correspond to the highest standards in order to draw sound conclusions?
One of the first facts we learn in renal physiology is that removing one kidney results in hyperperfusion and hyperfiltration and this in turn leads to damage of the remaining kidney with albuminuria and decreased renal function.
Is this also true for healthy living kidney donors? A study prospectively measured renal function by inulin and PAH clearance, albumin excretion and blood pressure before uninephrectomy and 1 week and 1 year after donation [ 4 ]. Albuminuria was found in two donors 1 week and in two donors 1 year after donation.
This carefully done study clearly shows that the first part we learned in renal physiology, i. Does this also result in a decline of renal function? Interestingly and against the theory, they found that renal function of the remaining kidney improves for many years in living donors. Mean eGFR of the investigated donors increased for 15—17 years after donation, remained constant for 8 years and only 23—25 years after donation the expected decline in renal function could be detected.
The strength of the study is the large number of living kidney donors, the long-time period after donation and the homogenous and strict criteria of donor selection, which did not change during the study period.
The disadvantage is the cross-sectional study design. From the original cohort of living donors, only donors were analyzed. Important for the finding of this study is the methodology, as the main result is not a direct observation but a calculation. However, the regression functions take into account both age at the time of the follow-up examination and time since donation as independent variables and therefore should be sound. What does the literature teach us about renal function after living donation?
A variety of studies were published, which tried to analyze renal function after donation and the long-term risk for kidney donors [ 8 , 9 ]. Probably, the largest single center investigated cohort consisted of kidney donors, who donated between and [ 10 ]. Interestingly, they also found that a longer time since donation was associated with a higher GFR and that renal function remained stable in donors with two serial GFR measurements.
However, of the kidney donors, only had GFR measurement and the course of renal function was analyzed in only 38 donors! Similar results were shown in a meta-analysis which summarized a total of donors in 48 studies from 27 countries [ 11 ]. How about proteinuria? The study of Fehrmam-Eckholm et al. A finding which was confirmed by most of the studies [ 11—15 ].
Urinary protein was usually reported to be higher in donors compared to controls and became more pronounced over time. Hemodialysis treatments are usually performed three times a week. Peritoneal dialysis is generally done daily at home.
A kidney specialist can explain the different approaches and help individual patients make the best treatment choices for themselves and their families. Kidney transplants have high success rates. The kidney may come from someone who died or from a living donor who may be a relative, friend or possibly a stranger, who donates a kidney to anyone in need of a transplant. Kidney disease usually affects both kidneys.
If the kidneys' ability to filter the blood is seriously damaged by disease, wastes and excess fluid may build up in the body. Although many forms of kidney disease do not produce symptoms until late in the course of the disease, there are six warning signs of kidney disease:. Skip to main content. How Your Kidneys Work.
Why Are the Kidneys So Important? The kidneys are powerful chemical factories that perform the following functions: remove waste products from the body remove drugs from the body balance the body's fluids release hormones that regulate blood pressure produce an active form of vitamin D that promotes strong, healthy bones control the production of red blood cells Below you will find more information about the kidneys and the vital role they play in keeping your body functioning.
Where are the kidneys and how do they function? Kidney disease causes Kidney disease diagnosis Kidney disease treatment Kidney failure treatment What are the warning signs of kidney disease? How is your kidney health? Use our online curriculum to get individualized information for your stage of kidney disease. Enter Kidney Pathways. COVID patients can become kidney patients. You can provide lifesaving support today with a special monthly gift.
Donate Now. Why do we have two kidneys when we can live with only one? This is a really great question. The answer is scientists are not completely sure but we do have some theories. That is often the case with science. Most of the animals you see above ground on Earth today, including humans, are the same on both sides. We have two eyes, two ears, and even two nostrils. If you look in the mirror and draw an imaginary line down the middle of your reflection you will see that you have an arm and a leg on each side.
If you had goggles that let you see your insides, you would see that you also have a kidney and a lung on each side too. And some animals still only have one kidney. Around million years ago, our long-lost relatives that were living in the ocean some of whom probably only had one kidney decided to leave the water to walk and live on land.
Avoiding contact sports and other activities that could cause an injury is one of the most important things you can do to keep your single kidney functioning well. Kidneys perform essential functions in your body, filtering waste and producing hormones.
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Health Conditions Discover Plan Connect. Living with One Kidney: What to Know. About Precautions Diet Alcohol Dialysis Monitoring Transplant Takeaway Although most people have two kidneys , you only need one functioning kidney to live an active, healthy life.
Keep reading to learn more about living with one kidney.
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