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How to treat a non-functioning kidney?

Tuesday, 10 September 2002
Answered by: Vijay Kher
Consultant Nephrologist
Indraprastha Apollo Hospital
New Delhi
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Q. My right kidney is not functioning (only 3.5% as confirmed by renogram). Left kidney is working well. Doctor advised me to take Repace-50 and Glycyphase(for controlling sugar). My blood and urine tests are normal and sugar is border line 150(pp). I am already taking Aatten-25, Simvotin-5, Bezolip-R 400 and Ecosprin-150 for my heart problem as I had angioplasty 6 yrs back. Presently I don't have any heart/other problem. My question is: 1)Whether Repace-50 helps in reviving the non functioning kidney and is it possible to revive the kidney by medicine? 2) Is Repace-50 an ACE inhibitor and does it reduce blood pressure? Should I stop taking Atten-25 or reduce the dose of other medicines? 3) As my right kidney is hydronephrotic and may be non functionig from my childhood( as other doctors guess), is there any chance of infection of left kidney? 4)Should I go for surgery of the right kidney for its removal-or is there other method to rectify the defect? 5) Few months back, psoriasis was detected on my right thumb by biopsy. Is it due to the reaction of the medicines? Is there any effective treatment for psoriasis? I had tried a number of ointments and vitamines as per the direction of skin specialists but they were of no use. Please suggest any suitable ointment/medicines. How effective is Dovonex? I would be highly obliged to have your esteemed opinion at the earliest for my further course of action.

A.  You have diabetes and non functioning right kidney which is hydronephrotic. You are 70 years old. If this hydronephrosis is since birth and you did not know about it till now, it is likely not to give trouble. There is however a small chance that it gets infected. -Depends also on how big is the kidney on ultrasonography. -Repace nor any other drug can revive the non functioning kidney. -Blood pressure control is important for heart and the other kidney which must remain well. -I do not think there is a chance of recovery of function in right kidney especially if it has been of such long standing duration. -Points in favour of removal: it might get infected or develop cancer though chances of both are small. If your heart is in good shape then surgery can be done. However, there is no indication for its removal urgently - such indications being intractable infection in urine, bleeding or severe pain. Psoriasis is not related to drugs. You will have to consult a dermatrologist for its treatment. I can not help you for this.

A.  You have diabetes and non functioning right kidney which is hydronephrotic. You are 70 years old. If this hydronephrosis is since birth and you did not know about it till now, it is likely not to give trouble. There is however a small chance that it gets infected. -Depends also on how big is the kidney on ultrasonography. -Repace nor any other drug can revive the non functioning kidney. -Blood pressure control is important for heart and the other kidney which must remain well. -I do not think there is a chance of recovery of function in right kidney especially if it has been of such long standing duration. -Points in favour of removal: it might get infected or develop cancer though chances of both are small. If your heart is in good shape then surgery can be done. However, there is no indication for its removal urgently - such indications being intractable infection in urine, bleeding or severe pain. Psoriasis is not related to drugs. You will have to consult a dermatrologist for its treatment. I can not help you for this.

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