Did you know I only have one functioning kidney?
I discovered a lump in my abdomen when I was 8 weeks pregnant with Doodlebug almost 5 years ago. My OB chuckled and told me it was probably just my organs moving to make room for my growing uterus and joked that I was so tiny that it was probably my kidney being pushed up. When it failed to stop growing and moving around (I marked my skin with sharpie to document its comings and goings), and it began to hurt, I went back 4 weeks later and insisted on an ultrasound.
Two hours after my scan, the OB called and asked me to “come in right away.” I was instantly sick to my stomach. She explained that the ultrasound showed a large mass, 11cm x 18cm, and they were unsure what it was. She wanted me to go for more tests and to see a surgeon for removal of what might be a cyst. At 12 weeks pregnant, the idea of abdominal surgery terrified me and every doctor I spoke with seemed unsure as well. Turns out, pregnant women make doctors (and their malpractice insurance) very nervous.
One day before my scheduled exploratory surgery, I had an ultrasound with a specialist to check on the baby. With one glance at the screen, she diagnosed me with an enlarged kidney. Apparently the first set of doctors didn’t put two and two together when the original ultrasound showed a large mass but noted that my left kidney could not be found.
I was then diagnosed with severe hydronephrosis of the left kidney, caused by a congenital defect that narrowed or blocked my ureteropelvic junction. Basically, the urine created by my left kidney couldn’t drain into my bladder, backed up into my kidney, and slowly destroyed the healthy tissue. All I had left was a thin membrane of kidney tissue filled with fluid.
Here’s a picture:
The good news? Hydronephrosis is benign in most cases. A severe urinary track or kidney infection is the largest threat I face because of the difficulty the doctors might have treating it. But the reality was that my kidney had most likely been this way for a while and I never knew it. It’s often diagnosed in infancy or childhood and corrected with a simple procedure, but mine was never caught. In fact, the human body can function just fine with only one kidney! This article from Scientific American describes how the remaining kidney can grow to compensate. Thankfully, my right kidney has done just that and has 99% function.
None of this was much consolation while I was pregnant (and an anxious mess) for the first time. Doctors weren’t sure how my still-functioning right kidney would do when the pressure from the pregnancy caused the expected (and totally normal) mild hydronephrosis of pregnancy in my right side. I was given options to stent the UPJ, to drain the kidney to relieve the pressure, or to do nothing.
I am grateful for the St. Louis urologist (because that’s where I lived at the time) who talked patiently with me while I weighed all my options. He treated me like an intelligent partner in my health decisions and was frank but kind about the risks. He helped me find a knowledgeable high-risk OB who monitored me closely, watching for signs of preterm labor and additional stress to my body and the baby’s. And he supported my choice when I decided not to undergo any procedures. He’s the kind of doctor everyone deserves.
My first pregnancy (and subsequent accidental second pregnancy) were thankfully unaffected by the kidney. I am not, however, symptom-free. The kidney is still huge. The size of a small loaf of bread or a large eggplant. It presses on nearby organs (including my intestines) and can be very uncomfortable if I move the wrong way or exercise too hard. I wish I had a copy of the MRI image to show you – it’s impressive how half of my abdomen is basically all giant-balloon-animal-kidney-thing.
The plan is to have it electively removed. I even had a surgeon all lined up to take it out laproscopically before I got knocked up with Bean (oops). My risk of kidney infection and my discomfort will both be ameliorated by its removal. Plus, there’s nothing like a good old nephrectomy to lose a few pounds. Kidding. Now is just not a good time – we’ll do it when the girls are a little older.
I used to think about how I was down one kidney all the time. It used to terrify me. Now it’s just another part of my day, but I do take good care of Ol’ Righty. Which is why I’m writing this post in the first place.
People, take care of your kidneys. Drink water. Pee when you have to – don’t hold it in. Assess your risks for kidney disease. Don’t take for granted the amazing work your body does for you. I sure don’t.