*How* Many Kidneys Do You Have?

To answer the question: I now have three kidneys. (Yes, three.) Two are working their way toward being retired, and one is now taking over.

Kidneys are the only organ where we get a pair when we really only need one. And it’s the only organ where a transplant means “add”, not “replace”. (They will remove kidneys that are cancerous or that have Polycystic Kidney Disease.)

Scar by Alan Turkus, on FlickrYears ago (actually, back when I first got sick), the only way to transplant a kidney was to make a really large incision from front to back. The kidneys are really well protected in the body, and they’re not easy to get to.

Also, this method was the only way to retrieve a kidney from a live donor. The photo in this post is of a live kidney donor in 2006, and techniques had already improved at that point. (The scar is relatively short.)

Over the year, techniques have improved. Now they use laparoscopic surgery to retrieve a kidney from a live donor, and the kidney is deposited into the recipient’s abdomen. (In my case, it’s on my right side. With the swelling, I look very weirdly pregnant because the right side is more swollen than the left. It’s also very close to the skin for some reason, so it’s actually visible. Or it will be when the swelling goes down.) The surgeon creates a new blood supply with an artery and two veins, and then creates a new connection to the bladder.

It can take time for the new kidney to get to work, although mine started working immediately. (If it hadn’t worked right away, they would have used temporary dialysis until it did.) And it takes time for the old kidneys to understand that they’re no longer being used. Doctors track the progress by using blood work, specifically Glomular Filtration Rate (GFR) and Creatinine, which both track kidney function:

  • My GFR was 17 when I checked into the hospital on Sunday. It was 18 on Monday; 19 on Tuesday; 23 on Wednesday; 28 on Thursday; 29 on Friday. It is 30 right now. (Normal for someone my age should be somewhere around 60.)
  • My creatinine level was 2.91 on Sunday. It was 2.67 on Monday; 2.55 on Tuesday; 2.21 on Wednesday; 1.87 on Thursday; 1.8 on Friday. It is 1.7 now. Normal is .6 to 1.5.

So as GFR goes up and creatinine goes down, it shows that the new kidney is taking over. It will be awhile until my numbers stabilize. Meanwhile, I’ll be getting labs done twice a week for at least the next month. (Good thing my phlebotomists like me, because they’re certainly going to be seeing a lot of me!)

My original kidneys will eventually shrink because they’re not being used. And my body will ignore them.

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