Concerns About Kidney Health: Atrophy and Function Tests

Q: Concerns About Kidney Health: Atrophy and Function Tests

Hello： 1. <br>A person only needs one normal kidney to manage bodily functions, so in your case, even though only the right kidney is functioning normally, your blood test results for kidney function and urinalysis are normal. <br>2. <br>The presence of foam in the urine without

Concerned about needing dialysis?

I underwent an ultrasound examination in 1999, which revealed left kidney atrophy.
I have been having regular health check-ups every two years, and my left kidney measures approximately 6 centimeters.
I have also had detailed examinations at a major hospital, where one doctor mentioned "floating kidney." I would like to ask Dr.
Yang the following questions:
1.
All kidney function tests, urine sediment microscopic examination, protein levels, glucose (AC), total cholesterol, BUN, creatinine, and uric acid are normal, except for uric acid which is 9.5.
Is this concerning?
2.
I often notice foam in my urine, and I experience frequent urination.
I need to urinate within half an hour after drinking water, and I continue to urinate a few minutes later.
I also wake up at night to urinate.
Could this be related to the atrophy of my left kidney, leaving me with only one kidney?
3.
I am also worried that my right kidney is atrophying.
If both kidneys become atrophied, will I need a kidney transplant or dialysis? The cause of my left kidney atrophy is unknown; a previous doctor suggested it might be congenital.
I have been under continuous monitoring, but I am genuinely concerned about the right kidney also atrophying.
4.
Are there any specific signs or symptoms that could indicate kidney problems, allowing me to detect issues early and seek urgent treatment?
5.
Does having normal BUN and creatinine levels mean that kidney function is normal?
Thank you very much, and I look forward to Dr.
Yang's response.
Thank you.

Beiji Xiong, 30~39 year old female. Ask Date: 2009/08/31

Dr. Yang Zhongwei reply Internal Medicine

Hello: 1.
A person only needs one normal kidney to manage bodily functions, so in your case, even though only the right kidney is functioning normally, your blood test results for kidney function and urinalysis are normal.
2.
The presence of foam in the urine without proteinuria in the urinalysis is reassuring.
3.
Frequent urination and nocturia are closely related to the bladder, so it is advisable to consult a urologist for an examination.
4.
If one kidney is congenitally atrophied, the other may undergo compensatory hypertrophy, which can increase the risk of hypertension, so please monitor your blood pressure, ideally keeping it below 130/80 mmHg.
5.
The decision to initiate dialysis depends on the kidney function indicated by blood tests and clinical symptoms.
If both kidneys are atrophied, the blood test results are likely to be abnormal, so caution is advised! 6.
Please regularly monitor urinalysis and blood tests for kidney function.
Ultrasound is also a good method to track the appearance of the kidneys.
7.
The kidneys do not cause pain, so it is essential to follow up as mentioned in point six.
Thank you for your guidance!

Reply Date: 2009/08/31

More Info

Dear Patient,
Thank you for your detailed inquiry regarding your kidney health, particularly in relation to your history of left kidney atrophy and your current symptoms. Your concerns are valid, and I appreciate the opportunity to address them comprehensively.

1. Understanding Kidney Atrophy and Function: Kidney atrophy, or renal atrophy, refers to the shrinkage of kidney tissue, which can occur for various reasons, including congenital abnormalities, chronic kidney disease, or vascular issues. The fact that your left kidney measures approximately 6 cm is indicative of atrophy, as a normal kidney typically measures around 10-12 cm in adults. Regular monitoring is crucial, especially since you have been advised that your left kidney may be congenitally small.
2. Normal Function Tests: You mentioned that your kidney function tests, including BUN (Blood Urea Nitrogen) and creatinine levels, are normal. This is a positive sign, as these tests are critical indicators of kidney function. Normal values suggest that your remaining kidney is functioning adequately, even in the presence of atrophy. However, it is essential to continue monitoring these parameters regularly, as kidney function can change over time.

3. Symptoms of Concern: The presence of foamy urine and frequent urination can be concerning. Foamy urine may indicate proteinuria, which is the presence of excess protein in the urine. While you noted that your protein levels are normal, it might be worthwhile to conduct further tests, such as a 24-hour urine protein test, to ensure that there is no intermittent proteinuria. Frequent urination, especially if it occurs shortly after drinking fluids, can be a sign of various conditions, including diabetes or bladder issues, and should be evaluated further.

4. Potential for Right Kidney Atrophy: Your concern about the potential for your right kidney to also undergo atrophy is understandable. If both kidneys were to become significantly atrophied, it could lead to renal insufficiency, necessitating interventions such as dialysis or kidney transplantation. However, this is not an immediate concern unless you start experiencing symptoms of kidney failure, such as fatigue, swelling, or changes in urination patterns.

5. Early Detection of Kidney Issues: To monitor your kidney health proactively, pay attention to any new symptoms, such as changes in urination frequency, swelling in the legs or ankles, fatigue, or changes in appetite. Regular follow-ups with your nephrologist are essential, and they may recommend periodic imaging studies or blood tests to track any changes in kidney size or function.

6. BUN and Creatinine Levels: While normal BUN and creatinine levels are reassuring, they do not always provide a complete picture of kidney health. Other factors, such as electrolyte levels, urine output, and the presence of any symptoms, should also be considered. It is crucial to maintain a dialogue with your healthcare provider about any changes in your health status.

In conclusion, while your current kidney function appears stable, it is essential to remain vigilant and maintain regular check-ups. If you experience any new symptoms or changes in your health, do not hesitate to reach out to your healthcare provider for further evaluation. Your proactive approach to monitoring your kidney health is commendable, and I encourage you to continue this practice.

Best regards,
Doctor Q&A Teams

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