Chemotherapy for Living kidney donors

[PastorJeff]

My wife works in a medical office and recently told her manager of my plans to donate.  She was supportive but raised a good concern.  If a donor gets cancer, is there a limitation on chemotherapy because of one kidney?  I still plan on going ahead but it might be nice to inform people if there is such a future limitation. 

[sherri]

Depending on how well your one kidney recovers may influence your ability to filter toxins. Living kidney donors are advised not to take NSAIDS (non steroidal anti inflammatories) because they are filtered through the kidney. Any nephrotoxic agents like chemo or other drugs will obviously need to be filtered through the kidney. You can discuss this with your nephrologist or get a second opinion from another physician. One of the reasons why they do the work up is to make sure that there are no underlying health issues but there are no guarantees and no physician can predict whether you will or won't get cancer. If there is a history of cancer in your family this is something you can talk about as well and see if you would still like to continue in the donation process. I did bring these issues up with the team and basically they say there are no guarantees. But when your family member is sick now and you are the match it is hard to back out on the what ifs. Ultimately, we all take a risk by donating a major organ that doctors refer to as a "spare". But I do often have that feeling like I am driving on my "spare" and pray I don't hit a pothole along the way.

Sherri

[Orchidlady]

I don't know specifically about donors with one kidney. However your question is quite interesting in light of two recent events I have experienced.  I have a business associate whose wife had to go on dialysis because chemotherapy destroyed her kidney function. We also talked to an individual last week who is currently on dialysis. His brother donated a kidney to him almost 30 years ago. He was treated for lymphoma which decreased his kidney function to the point of dialysis. He did say they had to adjust things to try to protect the kidney, but, unfortunately, it did not work. The good news is, the lymphoma is gone - but at the expense of the kidney.
I guess the upshot is, as Sherri says, there are no guarantees. Some people manage chemotherapy fine, and others, as noted above whether one kidney or two, do not.

[Rob_h]

In a related sense, my cardiologist is wanting to put me on IV antibiotics to treat lyme disease that has done damage to my natural pacemaker.  The problem is a lot of antibiotics are bad for the kidney.  In fact my son's kidney failed after he had IV antibiotics (vankamicin) to treat sepis. So its something to think about as you can never predict what health issues you might have "down the line" and how having one kidney might complicate treatment.

I still believe that donation was the right thing for me to do, given the risks to folks without transplants.  best wishes, Rob Halverson

[PastorJeff]

Thanks for all your thoughtful replies.  I know they want people to donate but is it too farfetched to discuss it for the purpose of  informed consent.  I suppose you can't cover every possible scenario. 

[WilliamLFreeman]

Rob,

I am sorry to learn that your son's kidney failed.  

If you had that info on LDO before, I had missed it -- or [given my age] forgotten it.

Bill

[Rob_h]

Hi Bill,

I created a misunderstanding, my son's orig. kidney failed back in 2003 due to  IV antibiotic treatment for sepsis, after which his friend Luke became is donor.  He is doing great.  Sorry for the misunderstanding. best, Rob

[CK]

For me, I just wasn't going to stress over whether or not some future health issue would arise that would be impacted by my having one kidney. I could get hit by a bus tomorrow. We can't know the future, we can never be certain of anything. Most things that'll hurt one kidney will hurt two.