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Treatment of hydronephrotic kidney

Tuesday, 20 August 2002
Answered by: Vijay Kher
Consultant Nephrologist
Indraprastha Apollo Hospital
New Delhi
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Q. I would like to draw your kind attention to the following facts regarding my health problem: 1) I don't have any abnormal blood/urine report; 2) Recently it has been detected that my right kidney is hydronephrotic and of gr-III status and this has been confirmed by IVP and radio active tracer technique(renogram). My right kidney is working only 3.6% while left kidney is contributing 96% (approx). 3) Urologist suggested immediate removal of right kidney as there is a chance for infection. 4) Nephrologist suggested not to go for operation as the defect may be from my childhood/birth and instead, advised Repace-50. 5) I don't have diabetes but had angioplasty 5 years back. 6) Presently I am taking Equagesic-150, Simvotin-5, Bezolip-R-400 mg, Atten-25 for my heart condition and recently started Repace-50 for the kidney problem. I would be highly obliged if you let me know your esteemed opinion regarding surgery-whether to go for operation or keep the kidney as it is till there is no problem.

A.  Since your right kidney has mostly no function (less than 10%) and it is obstructed and hydronephritic, there is a higher chance of infecion in this kidney and also a slight higher chance of malignancy in such a kidney. Though surgical removal is not indicated immediately, it may be prudent to remove this non-functioning kidney which has a potential for trouble in future and has no use now or in future. It is true that you may have had this problem since birth or childhood and lived 50 years. However, it is likely that its function was better earlier was therefore of use of to the body. Now it is not contributing to body's utility and so I would suggest you to choose an appropriate time to get the surgery done which could be done laparoscopically.

A.  Since your right kidney has mostly no function (less than 10%) and it is obstructed and hydronephritic, there is a higher chance of infecion in this kidney and also a slight higher chance of malignancy in such a kidney. Though surgical removal is not indicated immediately, it may be prudent to remove this non-functioning kidney which has a potential for trouble in future and has no use now or in future. It is true that you may have had this problem since birth or childhood and lived 50 years. However, it is likely that its function was better earlier was therefore of use of to the body. Now it is not contributing to body's utility and so I would suggest you to choose an appropriate time to get the surgery done which could be done laparoscopically.

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