Life with one kidney

Most people live normal, healthy lives with one kidney. However it is important to help your child to stay as health as possible and to protect the kidney they have.

What do the kidneys do?

Most people have 2 kidneys which produce urine to remove excess water and waste products from our blood. The urine in the kidneys passes into the bladder through tubes called ureters and then to the outside through the urethra (another tube) when urinating (going for a pee). Whilst most people do have 2 kidneys about 1 in 1000 children and adults only have one kidney or may have a normal kidney and one small kidney.

What are the causes of a single kidney?

A child may be born with only one kidney. This condition is called ‘renal agenesis’.

Some children are born with a kidney that doesn’t work because it has not formed normally and has lots of cysts. This is called a multi-cystic dysplastic kidney (MCDK). Often over time the abnormal kidney shrinks and can no longer be seen on scans.

A child may have one kidney removed during an operation in order to treat an injury or a disease such as cancer or extensive kidney stones.

What are the risks of my child only having one kidney?

Most children with a single, healthy kidney have very few problems. Often the healthy kidney is able to work harder so the overall kidney function is normal or nearly normal. However some long term problems have been seen in some people with 1 kidney such as:

• A slightly increased chance of developing abnormal amounts of protein in the urine and some abnormality in kidney function in early adult life.
• An increased chance of developing a slightly higher blood pressure than normal.

Does my child need regular check-ups and tests?

Most people with a single normal kidney have few or no problems, particularly in the first few years. However it is important we check to ensure your child’s kidney stays healthy so we will see your child every year and they will need the following tests:

• blood pressure check
• urine test to check for blood or protein
• height and weight check

Occasionally we will do blood tests to help us measure the overall kidney function. We may also do a scan or X-ray but these will not be done every year. When they are needed will vary for each child.

Will my child need to follow a special diet?

Children with 1 healthy kidney do not need to follow a special diet. However, it is important to encourage your child to have a healthy, balanced, low salt diet. It is also important they drink a good amount of fluid to keep their kidney healthy.

Will my child be able to take part in sports?

Physical exercise is important for all children to keep healthy. The likelihood of an injury during usual activities, sports and exercise is very low and much less than other injuries. Some sports, particularly at a competitive level, where a blow to the back area where the kidney is such as boxing, martial arts and rugby may have a higher risk, although this would still be a low risk to your child overall.

Are there any medications my child cannot take?

We would advise that you always mention your child has a single kidney to any healthcare professional starting your child on a new medication. This will allow them to decide if there is a medicine which might be better for your child.

You should avoid giving your child ibuprofen (sometimes called Nurofen) where possible. This is because ibuprofen can make the effects of dehydration on the kidney worse and cause damage to the healthy kidney. In most situations paracetamol is sufficient and can be given instead.