Kidney Health: Tests, Concerns, and Dietary Advice

Examination, health, and other related issues concerning having one less kidney?

Doctor Wu: Hello, over the past ten years, I have undergone abdominal ultrasounds three times due to gastrointestinal issues, and three different physicians have been unable to locate my right kidney.
They have all recommended that I see a nephrologist for further evaluation.
Based on this, I would like to ask the following questions:
1.
Regarding examinations:
1.
Is the evaluation for a missing kidney solely done through ultrasound, or would a CT scan be necessary?
2.
I need to apply for a diagnostic certificate due to military service requirements.
Can the examination results be used to issue such a certificate? What would the wording typically include?
2.
Related to physical condition:
1.
I have had frequent urination issues since childhood, and I need to drink a lot of water even without exercise or excessive sweating (I often feel thirsty).
I also feel more fatigued compared to my peers and often do not feel well-rested, experiencing significant sleep issues since the fifth and sixth grades (difficulty falling asleep, feeling unrested regardless of sleep duration).
If there are no other symptoms, no emotional distress, and my lifestyle and diet are relatively healthy, could the above issues be related to kidney problems?
2.
Is there a higher likelihood of developing diabetes or other kidney diseases after having a single kidney? (There is a family history of such conditions.)
3.
Is there a connection to hypospadias or recurrent urinary tract infections? (I do not have phimosis and have not engaged in sexual activity.)
4.
Is there a relationship with high myopia (approximately 1200 degrees)?
5.
Is the remaining left kidney enlarged due to compensatory mechanisms? Can it truly handle the workload? Could there be issues such as hormonal imbalances, like insufficient adrenaline secretion?
3.
Dietary concerns:
1.
Besides reducing salt intake, should I also decrease protein or fat consumption?
2.
Can I continue taking over-the-counter supplements such as multivitamins, soy lecithin, fish oil, digestive enzymes (like Wakamoto), calcium-magnesium tablets, and zinc tablets?
3.
Would drinking more water or coffee potentially create a burden?
Thank you for your guidance, Doctor.
Recently, I have started researching the human body and health due to kidney issues, and I find the things you study very interesting! XD Thank you.
I also wish all doctors and online friends good health.

Mr. Hsu, 20~29 year old female. Ask Date: 2018/04/25

Dr. Wu Hongjie reply Internal Medicine

1.
The diagnostic rate of ultrasound has already reached a high level, and computed tomography (CT) can enhance diagnostic accuracy.
However, it is recommended that if the results of a non-contrast scan indicate a single kidney, it should be classified as a Class A diagnosis.
The findings may indicate a congenital solitary kidney (which may not be visible on either ultrasound or CT).

2.
To determine if there are any issues with the kidneys, renal function indicators such as creatinine and glomerular filtration rate (GFR) must be assessed.
If these values do not indicate any problems, it is difficult to correlate your symptoms with renal dysfunction.
Individuals with a solitary kidney have a higher likelihood of developing renal dysfunction over time.
As for diabetes, there is no research showing a direct correlation between recurrent urinary tract infections and having a solitary kidney, but it may be related to abnormalities such as a duplicated urinary system or urinary tract obstruction.
For concerns regarding hypospadias, it is advisable to consult a urologist, as it is unrelated to myopia.
The adrenal glands and kidneys originate from different embryonic systems, thus there is no correlation.
Compensation is a natural response of the body; however, it is true that individuals with a solitary kidney may experience a decline in renal function more rapidly than those with two kidneys over the years.
3.
If renal function is normal and there is no proteinuria, there is no evidence that a low-protein diet benefits renal function.
Multivitamins have specific restrictions only in cases of renal dysfunction, particularly in stages three and above.
Increasing water intake does not have an adverse effect, while caffeine should be limited to about 300 mg per day.
Wishing you good health.

Reply Date: 2018/04/25

More Info

Dear Patient,
Thank you for your thoughtful questions regarding kidney health, diagnostic tests, and dietary considerations. Your concerns about your kidney health and overall well-being are valid, especially given your history of gastrointestinal issues and the absence of your right kidney as noted in previous ultrasounds. Let’s address your queries systematically.

1. Diagnostic Tests for Kidney Evaluation
To assess the absence of your right kidney, an abdominal ultrasound is a common first step. However, if the ultrasound results are inconclusive or if there is a need for more detailed imaging, a CT scan (computed tomography) may be recommended. CT scans provide a more comprehensive view of the abdominal structures and can help identify any anatomical anomalies or confirm the absence of the kidney.

Regarding your request for a diagnostic certificate for military service, the results from your kidney evaluations can indeed be documented by your healthcare provider. Typically, the certificate would state the findings, such as "The patient has undergone imaging studies revealing the absence of the right kidney," along with any relevant medical history and recommendations.

2. Health Concerns Related to Kidney Function
Your symptoms of frequent urination, excessive thirst, fatigue, and sleep disturbances warrant further investigation. While these symptoms can be associated with kidney issues, they may also relate to other conditions such as diabetes mellitus or hormonal imbalances. Given your family history of diabetes, it is essential to monitor your blood glucose levels and possibly undergo tests for diabetes.

The presence of a single kidney does not inherently increase your risk of developing diabetes; however, it is crucial to maintain a healthy lifestyle to mitigate any potential risks. Regular check-ups with your healthcare provider can help monitor your kidney function and overall health.

Your history of urinary tract infections (UTIs) and the condition known as hypospadias may contribute to urinary symptoms. Frequent UTIs can lead to kidney damage over time if not managed properly. It is advisable to discuss these concerns with a urologist or nephrologist who can provide tailored advice.

3. Dietary Considerations
Diet plays a significant role in kidney health. Here are some dietary recommendations based on your situation:
- Sodium Intake: Reducing salt intake is crucial for kidney health, especially if you have high blood pressure or are at risk for kidney disease.

- Protein and Fat: While protein is essential for health, excessive protein intake can strain the kidneys, particularly if there is pre-existing kidney damage. A balanced diet with moderate protein intake is advisable. Fats should be healthy fats, such as those from fish and nuts, rather than saturated fats.

- Supplements: Regarding your use of multivitamins, fish oil, and other supplements, it is generally safe to continue these if taken within recommended doses. However, it is essential to consult with your healthcare provider about specific supplements, especially if you have any underlying health conditions.

- Hydration: Staying well-hydrated is vital for kidney function. Drinking adequate water helps the kidneys filter waste effectively. However, excessive caffeine intake can lead to dehydration, so moderation is key.

4. Kidney Function and Lifestyle
Your remaining left kidney is capable of compensating for the loss of the right kidney, provided it is healthy. Regular monitoring of kidney function through blood tests (such as serum creatinine and glomerular filtration rate) is essential to ensure it is functioning adequately.

In terms of endocrine function, the kidneys play a role in hormone regulation, including the production of erythropoietin, which stimulates red blood cell production. If you experience symptoms such as fatigue or unusual weight changes, these could indicate hormonal imbalances that should be evaluated.

Conclusion
Your proactive approach to understanding your health is commendable. I encourage you to maintain open communication with your healthcare providers, who can offer personalized advice based on your medical history and current health status. Regular check-ups, a balanced diet, and a healthy lifestyle are key components in managing your kidney health and overall well-being.

Wishing you good health and well-being!
Best regards.

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