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Question: my son is 6 years male, height is 114 cm, weight is 19kg. Cretinine level is 69, dysplastic right kidney not function, and slightly scarred left kidney. Size of Right kidney is 4cm, left kidney is 8.2 cm. In the last year his growth as been the following grew from 106 to 114 went from 17kg to 19 kg. Left kidney grew from 7.7 to 8.2 cm. The issue i have is the specialist seems to change her mind on every annual visit. It goes from he needs a transplant right away to he looks ok, will have to wait till he reached puberty to determine if a transplant is needed. Is kidney growth not a good sign, that he may not need a transplant. In other words what is the worst case vs best case.
Forgot to add that his blood pressure is normal. His blood count is normal. the Doctor did not mention BUN levels, however she did say last year that they did improve.
Also forgot to add, that I was born with a right dysplastic kidney. Did not find out till 25, due to frequent UTI. Had Right kidney removed in 1998. My left kidney is fine, funtions at 87 percent. Son did have VCUG, when he was 6month, his left kidney which is scarred had a funtion of 85 percent.
Just some more info. In the last five years of follow up, there has not been any change to the working kidney ie no additional damage.
also Dr mentioned because only one kidney is working, the overall kidney function is at 60.
Forgot to add that his blood pressure is normal. His blood count is normal. the Doctor did not mention BUN levels, however she did say last year that they did improve.
Also forgot to add, that I was born with a right dysplastic kidney. Did not find out till 25, due to frequent UTI. Had Right kidney removed in 1998. My left kidney is fine, funtions at 87 percent. Son did have VCUG, when he was 6month, his left kidney which is scarred had a funtion of 85 percent.
Just some more info. In the last five years of follow up, there has not been any change to the working kidney ie no additional damage.
also Dr mentioned because only one kidney is working, the overall kidney function is at 60.
Brief Answer:
Need more info
Detailed Answer:
Hello
Thanks for getting back
I understand your anxiety. However in order to help you in a better way,I would like to know a few more details from you
1. You said that the Serum creatinine level is 69. Please mention the units
2. Does he have any symptoms? Like loss of appetite, vomiting, etc
3. Does he have any edema over the limbs?
4. Please mention the medications he is on currently
5. If at all, he has to undergo a renal transplant, who is the prospective renal donor?
6. When you say the function of the kidney is 60, are you suggesting his GFR?
Please get back to me, I am awaiting his reply
Regards
Need more info
Detailed Answer:
Hello
Thanks for getting back
I understand your anxiety. However in order to help you in a better way,I would like to know a few more details from you
1. You said that the Serum creatinine level is 69. Please mention the units
2. Does he have any symptoms? Like loss of appetite, vomiting, etc
3. Does he have any edema over the limbs?
4. Please mention the medications he is on currently
5. If at all, he has to undergo a renal transplant, who is the prospective renal donor?
6. When you say the function of the kidney is 60, are you suggesting his GFR?
Please get back to me, I am awaiting his reply
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi please see below
1. You said that the Serum creatinine level is 69. Please mention the units
Hi there i live in canada and i believe it is measured by (μmol)/L
2. Does he have any symptoms? Like loss of appetite, vomiting, etc
no symptoms, he has a large appetite and is growing. Growth last year was 6 cm, and 2kg weight gain.
3. Does he have any edema over the limbs?
No
4. Please mention the medications he is on currently
none. Doctor stated that he does not need any.
5. If at all, he has to undergo a renal transplant, who is the prospective renal donor?
right now, Doctor states none is needed. Will have to wait till he hits puberty.
6. When you say the function of the kidney is 60, are you suggesting his GFR?
yes GFR
1. You said that the Serum creatinine level is 69. Please mention the units
Hi there i live in canada and i believe it is measured by (μmol)/L
2. Does he have any symptoms? Like loss of appetite, vomiting, etc
no symptoms, he has a large appetite and is growing. Growth last year was 6 cm, and 2kg weight gain.
3. Does he have any edema over the limbs?
No
4. Please mention the medications he is on currently
none. Doctor stated that he does not need any.
5. If at all, he has to undergo a renal transplant, who is the prospective renal donor?
right now, Doctor states none is needed. Will have to wait till he hits puberty.
6. When you say the function of the kidney is 60, are you suggesting his GFR?
yes GFR
Just to add blood pressure normal. Blood work normal. Working kidney is 8.2 cm
Brief Answer:
Normal renal function
Detailed Answer:
Hello
Thanks for getting back
From the history you have provided it looks like your son is doing very well right now. He will not require transplant anytime soon. Most patients do well with a single kidney and so will your son.
However, the following things are very important in order to ensure good linear growth of your child
1. Bone mineralisation. Please make sure to check his calcium, phosphorus, alkaline phosphtase and Vit D levels every once in 6 months. Correction of these factors is imporant
2. He must avoid red meat. He can have sea food and lean meat ( chicken, etc)
3. Make sure he does not take pain killers of NSAID group like diclofenac, aceclofenac, brufen ,etc
4. It is important that he does not suffer from recurrent UTI. Please speak to your doctor about putting him in on oral prophylaxis
5. Speak to your doctor about putting him on ACE/ARB inhibitors. It gives good renal protection, I usually prescribe Enalapril once a day. This is a clinical decision which needs to be taken by your nephrologist based on 24 hour urine protein values or Urine protein creat ratio
Even at puberty he might require transplantation only if his GFR falls below 15 ( which is very unlikely if good care is taken)
I hope I was of help, if you have any further queries please get back to me
Regards
Normal renal function
Detailed Answer:
Hello
Thanks for getting back
From the history you have provided it looks like your son is doing very well right now. He will not require transplant anytime soon. Most patients do well with a single kidney and so will your son.
However, the following things are very important in order to ensure good linear growth of your child
1. Bone mineralisation. Please make sure to check his calcium, phosphorus, alkaline phosphtase and Vit D levels every once in 6 months. Correction of these factors is imporant
2. He must avoid red meat. He can have sea food and lean meat ( chicken, etc)
3. Make sure he does not take pain killers of NSAID group like diclofenac, aceclofenac, brufen ,etc
4. It is important that he does not suffer from recurrent UTI. Please speak to your doctor about putting him in on oral prophylaxis
5. Speak to your doctor about putting him on ACE/ARB inhibitors. It gives good renal protection, I usually prescribe Enalapril once a day. This is a clinical decision which needs to be taken by your nephrologist based on 24 hour urine protein values or Urine protein creat ratio
Even at puberty he might require transplantation only if his GFR falls below 15 ( which is very unlikely if good care is taken)
I hope I was of help, if you have any further queries please get back to me
Regards
Above answer was peer-reviewed by :
Dr. Deepak
Thanks for you answers. One more question. Can a dysplastic kidney grow to a normal size kidney? Or does it stay small?
No sure if this is relevant but my son was born with this. You may have already assumed this.
No sure if this is relevant but my son was born with this. You may have already assumed this.
Brief Answer:
Dysplastic kidneys
Detailed Answer:
Hello
Dysplastic kidneys are usually congenital and people are born with it. Dysplastic kidneys do not become normal in size simply because they lag behind during the normal development in the first place. They might function partially, more importantly the other normal kidney compensates for the dysplastic kidney by over functioning.
You can always get back to me with whatever doubts you may have.
Regards
Dysplastic kidneys
Detailed Answer:
Hello
Dysplastic kidneys are usually congenital and people are born with it. Dysplastic kidneys do not become normal in size simply because they lag behind during the normal development in the first place. They might function partially, more importantly the other normal kidney compensates for the dysplastic kidney by over functioning.
You can always get back to me with whatever doubts you may have.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Ok thanks just want to confirm that you understood my sons situation. Dysplastic right kidney not working and left kidney scarred 8.2 cm working . Gfr is 60. Was born with scar in the right kidney.
Brief Answer:
Understood your sons situation
Detailed Answer:
Hello
Thanks for the getting back
I have understood your sons condition where he has a single functioning left kidney which might have been scarred due to urinary tract infections. He also has a congenital dysplastic right kidney.
regards
Understood your sons situation
Detailed Answer:
Hello
Thanks for the getting back
I have understood your sons condition where he has a single functioning left kidney which might have been scarred due to urinary tract infections. He also has a congenital dysplastic right kidney.
regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Raju A.T
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