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Do we need to remove one kidney if there is a ureteric stone?

Q: My wife has a big stone in the ureter of her right kidney. Her doctor said that the stone had blocked the ureter and the kidney has lost its function. They did a test, which showed that the kidney was at a 5% functioning level. The doctor decided to remove the kidney and this was a shock to us. He said that there is no possibility of recovery as the kidney function, even if they removed the stone from the ureter. Is it a right decision? What if the kidney is not removed? We are worried. Please help.

A:Based on the limited information, it seems that your wife’s doctor undertook some of the tests including Renal scan studies which help to definitively comment on the degree of irreversible loss in the function of each kidney. And I also presume that the same tests including serum creatinine value probably showed a relatively well functioning left kidney. Though it is difficult to comment on the cause of loss of right kidney function in the above case, one of the common causes at such a young age would include possibility of recurrent kidney infection during childhood resulting in the irreversible damage to the kidney. Removal of a poorly functioning kidney should be undertaken only under certain conditions which include: certain birth defects (congenital abnormality) of the kidney which if left unattended may lead to serious complications; persistent serious infection of the kidney; poorly controlled blood pressure associated with its complications, inspite of being on more than 3-4 medications; severe ongoing bleeding from the kidney; injury(trauma) to the kidney and finally, the intractable pain related to the kidney. If your wife does not have any of the above conditions, I see no reason to pursue with the removal of her right kidney.

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