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What is the problem if there is only one kidney?

Q: My niece is 8 yrs old. She had the problem of bed wetting not only at night but also during the day as well. We consulted a doctor for some internal checkup. We came to know that she has only one kidney. Is this the reason for her urine problem? Should we go for a monthly urine test? Will she face any problems after marriage?

A:Being born with a solitary kidney though uncommon is not extremely rare. However, what determines its future course is the functional status of that kidney. If the remaining kidney is healthy and completely normal, it will not result in any complications. However, if this kidney is diseased it shall result in host of different problems. Such complications include increased serum creatinine, kidney failure, increased urination in night (which in children may result in abnormal bed wetting), elevated blood pressure, protein in urine etc. The description provided by you may suggest increased urination during night which is the earliest sign of mild kidney disease. Thus, I suggest that her kidney function be measured. This can be done in a variety of ways including measuring serum creatinine and blood urea and doing 24 hour collection of urine for creatinine clearance and urinalysis, besides internal check up. As far as her fate following marriage is concerned, it entirely depends on health of remaining kidney. If she has kidney failure, she will be at increased risk of elevated blood pressure and urinary tract infections. Depending on her level of kidney function and its progression, it may have an impact on her fertility. If her kidney is normal, she may not experience any problem at all.

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