Can you live without Kidney's?

Trauma Columnist · Jan 1, 2007

Yes indeed, it is quite common. Renal cell cancer is the first diagnosis that comes to mind.

DeLana_RN, BSN, RN · Jan 1, 2007

Agree with pp, living without kidneys is indeed possible. Some dialysis patients actually have their kidneys removed after developing ESRD because they cause certain problems (as in a recent pt of mine who had polycystic kidney disease). Also, as in your pt's case, CA is another reason.

Pts can be maintained on dialysis indefinitely (within limits, of course - the average survival time of ESRD pts on diaysis is 5 years, due to comorbidities). PD or HD are options; HD can sometimes be done at home as well. Of course, a transplant is the best tx modality, however with a CA pt this is obviously not an option.

HTH.

DeLana :)

gandgsand · Apr 10, 2008

I was diagnosed with ESRD in May of 04. In January of 05 I went on dialysis. In May of that year they removed both kidneys and my spleen (being fused to one kidney). Besides siezures associated with my kidney removal and a few other malodies I have been doing well with dialysis. Probably the most profound experience since their removal was my desire for liquids gone. I have had very few (maybe three) instances of thirst since my kidneys were removed.

bjazzycat · Jul 21, 2008

This is my first time EVER doing something like this, so I will probably make many mistakes. But, with a big Thank You to the creator, here it goes ...

I am not the patient, but my question is "Can you live without kidneys?" I read some of the threads, but am confused by some of the abbreviations. What is ESRD? What is PD or HD? Also, is it completely impossible for a patient who has had cancer in both kidneys, and had them both removed to get a kidney transplant? What are the guidelines for that? (The Dr. stated he did not see any evidence of any remaining cancer). I do not have the exact name of the cancer, but was told it is Renal Cell __something, that doesn't respond well to chemo. If a patient is a candidate for a transplant, how long after the surgery is one put on the list? I have read that a smoker is not a good candidate for transplant surgery, is that true?

I realize the patient will need to rely solely on dialysis from this point forward, but understand that it is quite possible to live a full life in this condition - is that correct? I know nothing about dialysis, but will attempt to educate myself about it. How often is dialysis done for someone with no kidneys? Is it possible to do it at home?

I appreciate any explanations users could offer.

Dialysister · Jul 22, 2008

ESRD=End Stage Renal Disease

PD=Peritoneal Dialysis

HD=Hemodialysis

talaxandra · Jul 26, 2008

End-stage renal disease is where a persons' kidney function is too low to adequately support life without support, around 10% or less of normal function. Obviously without either kidney there will be no function.

Peritoneal and haemodialysis are treatments that remove wastes and fluid from the body, in lieu or the kidneys doing so. Dialysis is not as effective as kidneys are, so people with kidney failure need to modify their fluid and food intake - for example, kidneys regulate the amount of potassium in the blood; dialysis is not as effective at getting rid of extra potassium, so people with ESRD can't eat too much potassium-rich food or their potassium level will become dangerously high.

The kidneys have eight functions, none of which we can replace fully. For this reason people with ESRD also need to take a variety of medications. As the body continually creates wastes and processes fluids etc, dialysis is not a one-off treatment. People with ESRD need regular dialysis for the rest of their lives, unless they have a successful transplant. How often this is done, and whether or not it's at home, depends on what kind of dialysis is being used, the physical and mental capacity of the person, and what support is available, among other factors.

Transplant drugs given to stop the recipient's immune system from rejecting the transplanted organ suppress normal immune responses. This includes the immune system's ability to detect and attack cancer cells; therefore people who've had organ transplants have a higher lifetime risk of developing cancer, even when they haven't previously been diagnosed with cancer. For this reason a history of cancer may be a factor in deciding whether or not a person will be eligible for organ transplantation.

I hope this helps.

tkgrubbs · Oct 28, 2008

Please contact me back!!! Both of my father's kidneys were removed in Oct 2006 and he is now having some problems with the toxin level when doing HD ....he feels there is no hope b/c everyone tells him the same thing...they have never treated anyone without any kidneys.Both of them were removed due to kidney cancer in both kidneys...I am looking forward to speaking with you! Thank you!

talaxandra · Oct 29, 2008

I've looked after a number of patients who've had both kidneys removed (because of cancer, polycystic disease and, in one case, by accident). Although any renal function is helpful, in terms of it exerting even a little influence over blood pressure maintainence, excretion, bone density etc, people without any renal function at all can still be effectively managed.

I can't speak specifically about your father's situation, both because it's against the Terms of Service to give advice and because (being neither a renal physician or having any knowledge of your father's condition) I don't know anything about him, his ciondition or his management. However, if the problem were related to bilateral nephrectomy (removal of both kidneys) it would show up almost immediately, not two years later.

It's not uncommon for people with renal failure, as with all chronic diseses, to have changes in their condition over time. Most often these changes are for the worse, as few chronic conditions resolve.

For the majority of my patients, a sudden change in their biochemistry (the 'toxins' removed in dialysis) usually means either that there's something else going on it their body, like another illness, or they've become less compliant with an aspect of their regime. The latter is much more common, and not surprising - it's really difficult to stick to the restrictive requirements of managing dialysis-dependent renal failure, particularly over time.

I hope this is of some help. If you or your father need support, a number of renal groups are available, depending what country you live in. To find some in your area type "renal (or kidney) support group" or "renal (or kidney) patient information" into google. I hope this helps.

tkgrubbs · Oct 29, 2008

thank you for responding so quickly! I feel as though my dad does not drink enough-he has no desire to drink anything and i told him he should at least drink the 14oz of water daily thinking that this would help with the toxin level removal mark going from 2.4 to a 1.34 over the last couple of times it was tested...it is comforting to know you have helped others who live without any kidneys,,,he feels so inadequent at times...produces no urine and noone here in richmond va has ever had both kidneys removed...he developed heart failure in june with function rate of 29%...any things you can think of to help us is greatly apprecitated! He is only 61 and has endured so much in the past two yrs...

Trauma Columnist · Oct 29, 2008

It is quite common to not have kidneys (in our dialysis population). I doubt that this is the first case that your father's nephrologist has seen. If that is so, I would sincerely urge you to seek a second opinion. Is there a nurse practitioner or physicians assistant at the dialysis unit? THat would be a good starting place. Otherwise, I would discuss your concerns with the physician.

talaxandra · Oct 31, 2008

I agree with trauma (above) that if you're concerned you should speak with your father's nephrologist and/or other practitioners. I know almost nothing about US geography, but I did think Richmond VA was on the larger side, so I'm surprised they've never had another patient with no kidneys.

It's expected that your father won't make urine - he had no kidneys, which are the organs that produce urine. Many patients with renal failure who do have kidneys have so little function that they produce no urine, either, so it's not at all uncommon.

It may not be a bad idea for your father to see a psychologist or psychiatrist (the chief difference being that the latter can prescribe medication), preferrably one with experience with renal disease. Depression is very common in all chronic progressive illnesses, particularly renal failure. For a lot of people depression kicks in after a period time on renal replacement therapy, when it becomes clear that being compliant with the regime still means general deterioration.

Even if he's not clinically depressed, having someone to talk to who's not invested in him personally may be helpful. It sounds like you're quite drained, as well, so make sure you're taking care of yourself as well as of your dad. Good luck.