Hi
I was originally going to post this on my own forum but figured I would get Bill's and all of our other medical professional's attention here easier.
I have begun the process of being evaluated as an organ donor - kidney - for a relative. The good folks at Brigham and Womens' have given me a pretty fair assessment of what I may be in for should I qualify but I would love the input from my Uechi/karate brethen.
thoughts, concerns,.........
Looking forward to your input.
John
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It's what we do!
Narrow that down a little--the evaluation, the surgery, the potential long term consequences? It's a whole lotta journey there. Nothing quite like receiving one, but...
The thing we worry about long term is the risk of kidney failure in the donor. It would seem that they'd lose half their function and if many elderly people have bum kidneys, well, their remaining one woulda konked out. Not to say that can't happen, but overall things go well:
"In conclusion, our study indicates that kidney donors have a normal life span, a health status that is similar to that of the general population, and an excellent quality of life; they do not have an excessive risk of ESRD. The majority of donors in our study had a preserved GFR, and their rates of albuminuria and hypertension were similar to those of matched controls."
Don't read too too much into it because the controls weren't really matched. Based on their comparisons, you would think that donating a kidney is good for you:
"Therefore, the estimated incidence of ESRD in donors would appear to be 180 per million persons per year, as compared with the overall adjusted incidence rate of 268 per million persons per year in the white population of the United States."
"Donors had a lower estimated GFR, lower systolic blood pressure, and a lower urinary albumin excretion rate (Table 2). Hemoglobin, glucose, cholesterol, triglyceride and high-density lipoprotein cholesterol levels were lower in the donors than in the controls. Donors were less likely than controls to be smokers and were less likely to report having received a diagnosis of cancer. Self-reported diabetes and use of antihypertensive medications were similar in the two groups. These patterns in self-reported conditions and laboratory measurements persisted beyond the first 20 years after kidney donation."
In other words, kidney donors are a highly selected group (good for you!). They have less cancer because you basically can never have had cancer to give away a kidney (this may have been less true in the past, but at least now we know you can give a recipient your melanoma 10 years after you were "cured" via transplanting cancer along with the kidney.
More at: http://content.nejm.org/cgi/content/full/360/5/459
The thing we worry about long term is the risk of kidney failure in the donor. It would seem that they'd lose half their function and if many elderly people have bum kidneys, well, their remaining one woulda konked out. Not to say that can't happen, but overall things go well:
"In conclusion, our study indicates that kidney donors have a normal life span, a health status that is similar to that of the general population, and an excellent quality of life; they do not have an excessive risk of ESRD. The majority of donors in our study had a preserved GFR, and their rates of albuminuria and hypertension were similar to those of matched controls."
Don't read too too much into it because the controls weren't really matched. Based on their comparisons, you would think that donating a kidney is good for you:
"Therefore, the estimated incidence of ESRD in donors would appear to be 180 per million persons per year, as compared with the overall adjusted incidence rate of 268 per million persons per year in the white population of the United States."
"Donors had a lower estimated GFR, lower systolic blood pressure, and a lower urinary albumin excretion rate (Table 2). Hemoglobin, glucose, cholesterol, triglyceride and high-density lipoprotein cholesterol levels were lower in the donors than in the controls. Donors were less likely than controls to be smokers and were less likely to report having received a diagnosis of cancer. Self-reported diabetes and use of antihypertensive medications were similar in the two groups. These patterns in self-reported conditions and laboratory measurements persisted beyond the first 20 years after kidney donation."
In other words, kidney donors are a highly selected group (good for you!). They have less cancer because you basically can never have had cancer to give away a kidney (this may have been less true in the past, but at least now we know you can give a recipient your melanoma 10 years after you were "cured" via transplanting cancer along with the kidney.
More at: http://content.nejm.org/cgi/content/full/360/5/459
--Ian
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Bill Glasheen
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Excellent observation.IJ wrote:
In other words, kidney donors are a highly selected group (good for you!).
The first thing to consider is that a live kidney donor is an uncommonly saintly individual.
Secondly... What you can conclude from the research Ian cited is that there's not a lot to worry about healthwise - if nothing happens to your remaining kidney.
As a martial artist though you need to consider that certain activities (like sparring) need to be carefully considered. I'm not saying don't do it; I'm just saying that risks are different. The body is redundant for a reason. I certainly wouldn't stay on the rugby team.
And slam dancing is probably out as well... 
Also consider that something like this is a major surgical procedure. You shouldn't go into a hospital and have your body cavity opened unless you really need to. Stuff can happen. If you catch an infection that resides in a hospital, that's not a good thing.
Good luck with your decision process and your choice.
- Bill
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Thanks for posting that, John. This hits close to home.
My grandson has been in the hospital for two days. He got very sick, went to the doctor and was sent home, thinking it was the flu. He went to school the next day and got so sick, he left school and ended up in the ER.
They did blood tests and found his creatinine levels very high so they admitted him for further tests. He has been moved twice now and he is at MCV because they have a Pediatric Nephrologist on staff there.
Because his kidneys appeared to be shutting down, they thought he might need to be put on dialysis. So far though they are flushing his system and watching his electrolytes, have run more tests, hesitant to do dialysis since it has repercussions as well.
If a match, I am prepared to give him one of my kidneys if necessary, so this information is great.
I have a family friend who gave one of her kidneys to a close friend, who had been going through dialysis and waiting for a kidney for quite a while. After the surgery, her friend immediately did fantastic. She did horribly and it was over a month before she could start feeling human again. It was really tough on her.
Dana is sending me info. She works with the kidney foundation, so all of this is good to know.
Thanks,
Vicki
My grandson has been in the hospital for two days. He got very sick, went to the doctor and was sent home, thinking it was the flu. He went to school the next day and got so sick, he left school and ended up in the ER.
They did blood tests and found his creatinine levels very high so they admitted him for further tests. He has been moved twice now and he is at MCV because they have a Pediatric Nephrologist on staff there.
Because his kidneys appeared to be shutting down, they thought he might need to be put on dialysis. So far though they are flushing his system and watching his electrolytes, have run more tests, hesitant to do dialysis since it has repercussions as well.
If a match, I am prepared to give him one of my kidneys if necessary, so this information is great.
I have a family friend who gave one of her kidneys to a close friend, who had been going through dialysis and waiting for a kidney for quite a while. After the surgery, her friend immediately did fantastic. She did horribly and it was over a month before she could start feeling human again. It was really tough on her.
Dana is sending me info. She works with the kidney foundation, so all of this is good to know.
Thanks,
Vicki
Last edited by chef on Sat Sep 12, 2009 2:13 am, edited 2 times in total.
"Cry in the dojo, laugh in the battlefield"
Wow Vicki, sorry to hear that. Do they have any idea what's wrong? Kids frequently bounce back from problems like this and can even end up dialysis after an acute kidney injury (eg, post- strep throat nephritis) and then return to normal function over time. So I hope its one of those issues.
Having a single kidney would also make me hesitant to enter into any situations that could harm my remaining function. I would want:
--To use nsaids (motrin, others) cautiously or not at all (I already do this)
--To avoid dehydration
--Stay away from certain antibiotics, usually pretty easy (aminoglycosides, amphotericin--on the other hand, we only use these things if we have to)
--Avoid / minimize exposure to contrast dye (used in CT scans, cardiac cath, etc)
--Don't get injured--although, who's actually met anyone who lost a kidney doing sports?
--Control any present or future medical issues, especially diabetes or hypertension, very well
--Avoid obesity. Certain conditions (focal and segmental glomerular sclerosis, if you cared) are tied to kidney/body mass ratio and are more common (but not frequent) when there is less kidney or more body mass. Of course, there are better reasons for fitness for all of us already.
As for having an elective surgery... well, you shouldn't be there very long and thus such problems as blood clot prevention is less likely to come up, but you definitely do not want to let anyone touch you unless you've seen them gel their hands / you know the equipment was cleaned.
Also you need to be prepared for the psychological issues that can arise if you have a surgery give up a kidney and then the thing has "primary nonfunction" or konks out within a few weeks or years. That would really bum me out.
Having a single kidney would also make me hesitant to enter into any situations that could harm my remaining function. I would want:
--To use nsaids (motrin, others) cautiously or not at all (I already do this)
--To avoid dehydration
--Stay away from certain antibiotics, usually pretty easy (aminoglycosides, amphotericin--on the other hand, we only use these things if we have to)
--Avoid / minimize exposure to contrast dye (used in CT scans, cardiac cath, etc)
--Don't get injured--although, who's actually met anyone who lost a kidney doing sports?
--Control any present or future medical issues, especially diabetes or hypertension, very well
--Avoid obesity. Certain conditions (focal and segmental glomerular sclerosis, if you cared) are tied to kidney/body mass ratio and are more common (but not frequent) when there is less kidney or more body mass. Of course, there are better reasons for fitness for all of us already.
As for having an elective surgery... well, you shouldn't be there very long and thus such problems as blood clot prevention is less likely to come up, but you definitely do not want to let anyone touch you unless you've seen them gel their hands / you know the equipment was cleaned.
Also you need to be prepared for the psychological issues that can arise if you have a surgery give up a kidney and then the thing has "primary nonfunction" or konks out within a few weeks or years. That would really bum me out.
--Ian
Off subject for just a moment:
Great news! My daughter contacted me to tell me that his labs came back. He has plateaued which means he is on the road to recovery.
Thank God!
Thanks for all of you who prayed and encouraged me.
It's a great day!
Regards,
Vicki
Great news! My daughter contacted me to tell me that his labs came back. He has plateaued which means he is on the road to recovery.
Thank God!
Thanks for all of you who prayed and encouraged me.
It's a great day!
Regards,
Vicki
"Cry in the dojo, laugh in the battlefield"
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Bill Glasheen
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Shana Moore
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Quick and final interruption of this thread:
The doctore released my grandson because his kidneys are working, his blood pressure is back to normal, and he is finally able to hold food down.
He is home, having missed his first week+ of school.
I wanted to thank each of you who contacted me to encourage me and offer prayers. I am endebted.
Best regards,
Vicki
The doctore released my grandson because his kidneys are working, his blood pressure is back to normal, and he is finally able to hold food down.
He is home, having missed his first week+ of school.
I wanted to thank each of you who contacted me to encourage me and offer prayers. I am endebted.
Best regards,
Vicki
"Cry in the dojo, laugh in the battlefield"
God bless.-
Rising Star
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