Chronic Kidney Disease With One Kidney
Having a solitary or single kidney may be due to renal agenesis or renal dysplasia and may be due to several reasons but this blog is focused on Chronic Kidney Disease (CKD) with a solitary kidney. I’m interested in that because my wife Deborah has had this condition after having a nephrectomy almost 7 years ago, having previously been found to have CKD several years earlier. Since then, we have closely monitored her condition along the lines of more “normal” CKD but with some notable differences.
test results
Following Deborah’s nephrectomy, her kidney function (measured as eGFR) recovered significantly and gradually doubled in 4 years before falling back to a current figure similar to that considered normal with single kidney. So we have been relatively relaxed about this so far. And some other serum test results related to kidney disease progression have thankfully been generally stable and within normal ranges to-date e.g. key minerals including calcium, phosphorus, sodium, magnesium and potassium.
But other results have been less encouraging in terms of monitoring and management of her CKD, in particular urinary albumin, a type of protein, which has increased rapidly in recent years. I believe that the solitary kidney plays a major role here. Whilst there’s relatively little information on solitary kidneys via online research, I did discover that related, increased albuminuria was reported as far back as 1988. With further detailed research, I found several other references to this including from the National Institute of Diabetes and Digestive and Kidney Diseases (a mouthful, so commonly referred to as NIDDK!) which reports “increased protein in the urine, known as albuminuria” as a possible complication with a solitary kidney.
is proteinuria the same as albuminuria?
But that leads to another question – are albuminuria and proteinuria precisely the same thing? Some relevant “experts” suggest that they are not and it has actually been recommended that measuring proteinuria rather than albuminuria may be better for non-diabetics. So proteinuria may be a better monitor for Deborah who is not even pre-diabetic (more below). But that has also increased significantly in recent years albeit not quite as rapidly as albuminuria and with some respite and it is still within the range where her NHS nephrologist seems not to be too concerned. But we certainly can’t be complacent….and WE aren’t!
main cKD causes
The 2 main causes of CKD are diabetes and hypertension and so we monitor Deborah’s blood sugar and blood pressure at home on a regular basis and I encourage others with CKD to do likewise. My son Oliver (qualified Nutritional Therapist at OC NutriHealth) has been managing both of those key parameters for his mum. And this has been positive when she has not diverted from his straightforward protocol, for example:
Her weight has gradually decreased over the years.
A few months after her nephrectomy, her blood pressure was controlled so well that she was able to wean off BP medication and is still drug-free and normotensive.
controlling weight and Blood pressure
Unsurprisingly it appears quite clear that her weight and BP are linked. Recently I plotted her BP from 2017 until the present time and that clearly indicated cycling of BP with increases largely corresponding with Christmas time (those mince pies etc, Deborah!) followed by subsequent recovery from January onwards (“back to the gym” time!). Because of the clear effect on her health, we have recently noted a stronger determination in her efforts to maintain sustainable weight loss. So that should aid her CKD which, whilst generally a progressive disease, can be successfully managed to halt or reduce that progression.
Additional support
Whilst weight and BP control are vital in our battle with CKD, there are other things to consider. Melatonin - a hormone that controls sleep patterns - has been reported to help with CKD. This can include reversal of key pathologies e.g. increased reactive oxygen species and/or activity of the renin-angiotensin system, which can enhance the progression of CKD to end-stage renal disease. Melatonin’s anti-oxidant properties have been reported as beneficial in reducing albuminuria with such potential benefits supported in scientific studies. So it may be worth considering via diet and/or supplementation - if nothing else, it should improve Deborah’s sleep pattern which is variable.
Chronic Kidney Disease can be very challenging to manage at the best of times with constant monitoring of various serum and urinary test data. A solitary kidney offers an extra degree of difficulty, if only because of the relatively limited scientific evidence available. But nutrition and lifestyle clearly play key roles in CKD management and have been very helpful in our journey to-date. They should help us in future too.
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Disclaimer:
This blog is produced using recorded personal information and has been compiled in good faith for educational purposes. It also includes reference(s) to other information provided by relevant organisations sourced via the internet and my related interpretation. Whilst every effort has been made to ensure the accuracy of the above, I cannot accept liability for any unknown errors, omissions or misinterpretation of the information.
The information provided is not a substitute for professional medical advice which can be sought from a medical professional or other healthcare provider.
