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Kidney Diseases

Reflux as a Child - Outlook/Prognosis

10/04/2011

Question:

I`m a 26yr old male. I had bi-lateral reflux on `double kidneys` when I was a baby. I had anti-reflux surgery when I was 5 years old I think to correct the reflux.

As a result of the reflux my left kidney is damaged and shrunken and a renogram shows good drainage on both kidneys, but that the right kidney does about 80% of the work and the left 20%.

I have annual blood work which has shown my kidney function to be stable since that time. My last eGFR was 100ml/min with a creatine of 85 umol/l. It is usually around that; eGFR has been around 90/100 ml/min and stable.

I was just wondering if you could tell me whether I am likely to have any problems with my kidneys in the future.

My nephrologist said that he does not consider that I will have any problems and that I can continue to drink alcohol (as if I had two kidneys). I would just like a second opinion.

Answer:

The main long-term concerns in your case would be high blood pressure and kidney infection. The damaged kidney significantly increases your risk of elevated blood pressure, because the kidneys produce a hormone, renin, that regulates blood pressure. You should have your blood pressure checked once or twice per year, and if it is elevated, it should be treated and monitored. You might have an increased risk of kidney infection also, so it is important to drink plenty of fluids and empty your bladder regularly. Assuming that these issues are controlled, your kidney function should remain fine over time, assuming your "80%" kidney is healthy. As you know, many individuals have only one kidney and have a normal life expectancy.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University