Nephrectomy...or not

[couillardm]

Dr Goldfarb,

As a mentioned in my last post,my two and a half years old daughter is scheduled for a left nephrectomy next month since her left kidney has a 5% function according to the DMSA. The left kidney look healthy at the echography and is the same size as the right one which never had a single stone. Would it be a good idea to leave the left kidney there so he could keep on taking all the heat(stones) sparing the right one. I'm afraid stone formation will start in the right one as soon as the other is gone. What would be the downfall of leaving a 5% functionning kidney in there and, can he picked up some % in function with time or is it over for him?

Thanks

Michel

[DAVIDGOLDFARB]

Michel,
this is a difficult spot...more so for you, but me too. Remember that I am NOT practicing medicine here...I have not seen her chart, lab results, or imaging studies. But I think you are actually asking exactly the right questions. without knowing certain details, I don't see a reason to take out this kidney. If it is not infected why take it out? I agree that the nephrectomy of the bad kidney does not cure the disease, just dares the other kidney not to get stones too. And that kidney was growing for a while and achieved a reasonable size. So I do not know why exactly it has to be removed.
I ran your question the other day by a leading pediatric kidney stone expert who was not willing to comment much without more data but definitely thought you needed a second opinion. why not? It just costs money. If you want to do this I can help send you to the right people...in New York, Minnesota, or anywhere else. Let me know.

[couillardm]

Dr Goldfarb,

Yes,I would appreciate a second opinion. We live in Montreal,QC,Canada but willing to go to New York or somewhere else if necessary.

email: mcouillard262@hotmail.com