Essential Care Tips for Living with One Kidney - Internal Medicine

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Precautions for Having One Kidney


Hello Dr.
Huang,
I was born with only one kidney on the left side (the right kidney was absent at birth).
Recently, my routine blood tests have been normal, but an ultrasound revealed that my remaining kidney has enlarged slightly due to compensation.
However, there are currently no issues with kidney function.
I would like to ask if there are any special precautions I should take.
1.
Recently, I accidentally scratched myself on a rusty railing, and after evaluation, the doctor administered a tetanus vaccine.
I would like to know if the tetanus vaccine has any effects on the kidney.
2.
I regularly take medication for insomnia (I am currently tapering off as per my doctor's instructions).
I would like to know if these two medications are metabolized by the kidneys:
- Half a tablet of SILENCE TABLETS (LORAZEPAM) [https://info.fda.gov.tw/MLMS/H0001D.aspx?Type=Lic&LicId=01019247]
- A quarter tablet of Apo-Zopiclone Tablets 7.5mg [https://info.fda.gov.tw/MLMS/H0001D.aspx?Type=Lic&LicId=02024626]
3.
In addition to reducing sugar, salt, and oil in my diet, is there anything else I should pay special attention to? (I drink 2000cc of water daily.) For example, is it okay to have a medium-sized Americano and unsweetened green tea from a convenience store each day? What about my intake of protein and carbohydrates?
Since I only have one kidney, I hope to be proactive while I am still young and healthy.
Thank you for your assistance, Dr.
Huang!

Lun, 20~29 year old female. Ask Date: 2024/04/04

Dr. Huang Yaoxuan reply Internal Medicine


Hello Mr.
Lun: "Having only one kidney" means that you need to pay attention to certain aspects of daily life, which are similar to those of individuals with two kidneys.
However, the situation may differ in cases of acute kidney injury, such as acute pyelonephritis, which is a disease caused by bacterial (mostly bacterial) infection of the kidney.
The infected kidney's function (i.e., renal function) will deteriorate.
In individuals with two kidneys, the unaffected kidney compensates for the function of the infected one (this is known as compensatory phenomenon), so there is not much change in overall renal function.
However, for someone with only one kidney, there is no other normal kidney to take over the function of the infected kidney, which may lead to acute kidney injury, and renal function could significantly decline.
Regarding the two insomnia medications you mentioned, Lorazepam and Apo-Zopiclone, I recall that they are primarily metabolized by the liver and have little relation to the kidneys.
As for the tetanus vaccine, the main concern is to monitor for any allergic reactions, as it does not have other effects on the kidneys.
Thank you for your inquiry.

Reply Date: 2024/04/04

More Info


Living with one kidney, whether due to a congenital condition or surgical removal, requires careful attention to health and lifestyle choices. Here are some essential care tips for individuals with a single kidney, along with answers to your specific questions.


General Health Maintenance
1. Regular Check-ups: It is crucial to have regular check-ups with a nephrologist to monitor kidney function. Blood tests to check creatinine levels, glomerular filtration rate (GFR), and electrolyte levels are essential to ensure that the remaining kidney is functioning well.

2. Blood Pressure Monitoring: High blood pressure can be detrimental to kidney health. Regularly monitor your blood pressure and maintain it within the normal range. If you have hypertension, work with your healthcare provider to manage it effectively.

3. Hydration: Staying adequately hydrated is important, but the amount of water you should drink can vary based on individual health conditions. Generally, drinking around 2 liters (about 8 cups) of water per day is a good guideline, but this can be adjusted based on your activity level and any other health issues.

4. Dietary Considerations:
- Low Sodium: Reducing salt intake can help manage blood pressure and reduce the workload on the kidneys. Aim for less than 2,300 mg of sodium per day.

- Protein Intake: While protein is essential, excessive protein can strain the kidneys. It’s advisable to consult with a nutritionist to determine the right amount of protein for your specific needs.

- Balanced Diet: Focus on a diet rich in fruits, vegetables, whole grains, and healthy fats. Limit processed foods, which often contain high levels of sodium and unhealthy fats.

5. Exercise: Regular physical activity can help maintain a healthy weight, lower blood pressure, and improve overall health. Aim for at least 150 minutes of moderate-intensity exercise each week.


Specific Questions Addressed
1. Tetanus Vaccine and Kidney Health: The tetanus vaccine is generally safe for individuals with one kidney. It does not have any adverse effects on kidney function. However, always inform your healthcare provider about your kidney condition before receiving any vaccinations.

2. Medication Metabolism:
- Lorazepam (SILENCE TABLETS) and Apo-Zopiclone are primarily metabolized by the liver, not the kidneys. Therefore, they should not pose a significant risk to your kidney function. However, it is essential to follow your doctor's guidance on dosage and usage, especially since you are reducing the dosage.

3. Dietary Choices:
- Drinking moderate amounts of coffee (like a cup of Americano) and unsweetened green tea is generally acceptable. These beverages can be part of a healthy diet, but moderation is key.

- When it comes to carbohydrates, focus on complex carbohydrates such as whole grains, fruits, and vegetables. These provide essential nutrients and fiber, which are beneficial for overall health.


Additional Considerations
- Avoiding Nephrotoxins: Be cautious with over-the-counter medications and supplements that can harm the kidneys. Always consult your healthcare provider before starting any new medication or supplement.


- Limit Alcohol: Excessive alcohol consumption can negatively impact kidney function and overall health. If you choose to drink, do so in moderation.

- Stress Management: Chronic stress can affect your overall health, including kidney function. Engage in stress-reducing activities such as yoga, meditation, or hobbies you enjoy.

In conclusion, living with one kidney requires a proactive approach to health management. By following these guidelines and maintaining open communication with your healthcare team, you can lead a healthy and fulfilling life. Always consult with your healthcare provider for personalized advice tailored to your specific health needs.

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