Dear bradwitt & brother,
I am sorry that your brother had such a severe adverse event due to his living kidney donation to you.
You and your brother's experience with your physicians distresses me a great deal. (I am a 72 year old Family Physician about 100 K south of you [Bellingham, WA, USA] -- and a non-directed living kidney donor.)
As a member of the medical profession, I apologize for the kind of non-transparent, non-helpful, care your brother received regarding that adverse event. It was bad enough to have a medical or surgical complication of his donation to you; the quality of *caring* they then gave him should have been much better. :-)
To begin to answer some of your (and his) questions, I searched the medical database I subscribe to, "UpToDate"; the information there about the outcomes of people with acute renal failure (ARF) was last updated March 2013. I also searched information from the UNOS (United Network of Organ Sharing, USA) database; UNOS data are pretty complete and reliable for this issue.
1] The UNOS data show that ARF immediately following donor nephrectomy is extremely rare.
2] I cannot tell why it happened, from what you wrote. IF your brother wants to know what happened and why, your brother needs to get a copy of his entire medical and surgical records (including the operative report and all lab tests), and have a nephrologist, or knowledgeable Family Doctor or Nurse Practitioner, read them and "translate" them for him, as Sherri & others posted. Any of the professionals I list should be able to "translate" them. Doing so is important for my next point.
3] ARF is caused by several different causes. Your brother's prognosis depends in part on knowing the specific cause of the ARF. By "prognosis," I mean determining his likely future medical course, that is, his long term outcome or impact on his future health.
4] The best provider to understand your brother's likely prognosis is a nephrologist. As I understand BC's (British Columbia's) medical care system, if he wants "one-stop" medical care, then, it would be best for his primary care provider to refer him to a nephrologist, both to "translate" those medical and surgical records into plain English to describe what happened, and then to discuss his prognosis.
5] Doctors used to believe that ARF did not produce any adverse long-term consequences. Several good research reports about long-term outcomes of ARF, however, now show that some people who had ARF are at higher risk to develop chronic kidney disease. That higher risk is influenced by several factors, including older age (60+ or 65+ especially), duration of the decrease in kidney function (e.g., greater than 3 months), and others. UpToDate did not report any study or information about ARF that occurred in otherwise healthy people (like your brother, who was healthy enough to donate) due to the surgery to remove one kidney. I doubt anyone has reasonable information about that.
6] If I had suffered ARF due to my donation, I would have wanted to learn about my prognosis -- and even more important, learn from my nephrologist what I could do to minimize the chance that I would experience a long-term adverse outcome. It is your brother's choice, of course.
7] I, and LDO Online, do know some general things to maximize one's health and minimize the chance of developing chronic kidney disease, and to slow its speed of development if it does start. Here is part of what I wrote about prevention of CKD in a prior post on LDO a while ago titled "GFR vs. Creatinine Clearance," that Sherri just "bumped" to near the top on the list. I recommended that "all LKDs, including I, should continue to worry, no matter what our eGFR or mGFR is -- but worry productively. Why do I recommend that all us LKDs be worried? God, evolution, or God through evolution [your choice], gave us 2 kidneys for a reason. The second kidney is NOT "superfluous." It is a kidney in reserve, in case something bad happens to one kidney, or chronic kidney disease starts. (If people with chronic kidney disease have 2 kidneys, the disease will progress more slowly.) We LKDs gave away our "reserve kidney" to someone else. We LKDs thus should worry productively, about what we can do to take good care of our one kidney.
"What should productive worry focus on? Making sure our one kidney is happy and healthy, by adopting a lifestyle that follows what Donna and so many others have preached here on LDO:
* measure blood pressure and blood glucose at least yearly;
* follow a healthy lifestyle even more carefully than before donating (= low salt, low fat, diet; moderate exercise 30 min/day 5 days a week);
* treat "pre- high blood pressure" (systolic 130+ or diastolic 80+) with more life-style adjustment (more intense diet, exercise, etc.), and if needed medicines -- to prevent actual high blood pressure;
* if overweight, prevent type 2 diabetes with more life-style adjustment (more intense diet, exercise, etc.);
* prevent heart attacks, strokes, and blockage of the larger arteries to the kidneys by keeping cholesterol levels where they should be by diet, and by medicines if needed;
* if high blood pressure or diabetes does/do develop, treat / manage it/them aggressively with diet, exercise, weight loss, and probably medicines."
I wish and hope for the best for you and especially your brother -- that his ARF resolves completely, and you both live a happy life with complications (although we know you will have to take medicine to prevent rejection).
Since we live so close (at least relatively), separated by only the White Rock - Blaine border crossing, perhaps we could get together, if you like. About once a year I pass by close to your brother, on the way to Maurelle Island (east and north of Campbell River, BC), and perhaps he and I could meet as well.
Bill
Topic: creatinine level on donor increased from 88 to 500 post transplant (Read 20735 times)