Is it possible to give birth with one kidney: planning conception, features of pregnancy, indications and contraindications

Kidney functions

The kidneys are a paired bean-shaped organ, weighing from 120 to 200 g each (in adults). Their localization is the posterior wall of the peritoneum, to the right and left of the spine, at the level of the upper thoracic and lower lumbar vertebrae (the left one is located 1-1.5 cm above the right). They perform several functions, but the main one is excretory.

It is carried out by excreting urine, which contains water and the end products of the body's metabolic processes dissolved in it. Substances that are not needed are removed from the body through urine. Urine is formed as a result of the filtration and secretion functions of the glomerular nephron system.

Another important task of the kidneys is to:

Endocrine function. As a result of the work of the kidneys, the hormone renin is synthesized (participates in water balance, regulates the volume of circulating blood), erythropoietin (stimulates the maturation of red bone marrow red blood cells), prostaglandins (participate in the regulation of blood pressure).
Metabolic. This includes the synthesis of vitamin D3 (a more active form) from vitamin D; maintaining a certain ratio between proteins, carbohydrates, fats in the internal environments of the body.
Ion-regulating. Human blood contains substances that determine an alkaline environment (hydrogen ions) and an acidic environment (bicarbonate ions), the balanced ratio of which is regulated by the kidneys.
Osmoregulatory. Paired organs provide the required concentration of potassium and sodium ions to maintain osmosis.

It should be understood that if normally there should be 2 kidneys, then the absence of one of them is a pathology, despite the fact that clinical practice indicates the possibility of living with it. At the same time, it is imperative to lead a healthy lifestyle.

It includes a proper diet with strict limitation of the consumption of salty, fatty, spicy, etc., absence of excessive physical activity, careful prevention and timely treatment of the infectious process.

Video: A cancerous tumor was removed from a single kidney for the first time in Barnaul

The kidneys remove waste and excess water from the blood to form urine. Urine flows from the kidneys through the ureters to the bladder.

Most people with a solitary kidney live normal, healthy lives. Precautions must be taken to preserve the function of the solitary kidney.

What are the possible effects of a solitary kidney?

If having a solitary kidney does affect your health, the changes will likely be so small and happen so slowly that you won't notice them. However, these gradual changes over a long period of time may require certain measures or treatment.

Changes that may be associated with a solitary kidney include the following:

Increased blood pressure

The kidneys maintain normal blood pressure by regulating the volume of blood circulating in the bloodstream and also by producing the hormone renin, which works in conjunction with other hormones to dilate or constrict blood vessels. Many people who lose or donate a kidney may have high blood pressure several years later.

Proteinuria.

The presence of protein in the urine, called proteinuria, is a sign of kidney disease. People often have protein in their urine after living with a single kidney for several years.

Possible consequences

One kidney is a pathology either hereditary or acquired. There is evidence indicating that 5 out of 1000 people suffer from it. The congenital absence of an organ is called agenesis. It occurs due to disturbances during intrauterine development.

More often, agenesis is unilateral; if it is bilateral (both kidneys are absent at once), the death of the born child is almost instantaneous. But sometimes one-sided ones are not even discovered right away. If the only organ functions normally, then there are no visible symptoms of pathology. And only during preventive diagnostic studies is agenesis detected.

A kidney is removed (nephrectomy) when diseases such as pyelonephritis, kidney stones, tumor, polycystic disease, etc., do not respond to conservative (with the help of drugs) treatment. It is reliably known that one kidney can perform the functions of both by 75%; this is ensured by the high compensatory abilities of the paired organ.

To perform the necessary functions, a single organ can increase almost 2 times in size. Each healthy kidney has reserve nephrons (cells), which begin to work only if the constantly functioning nephrons fail. Immediately after nephrectomy, these reserves are put to work, the organ becomes hyperemic (reddened) and increases in size (hypertrophy).

The work of the removed organ will be fully compensated in a year and a half. And even in one normally functioning kidney, over time, some of the nephrons become reserve, since the subsequent loss of kidney cell function is possible due to constant work with a double load.

Given these facts, women who want to give birth should plan a pregnancy 2 (or more) years after the loss of one of the kidneys. During this time, compensatory functions will be fully restored, and the functional reserve of one working organ will not be exhausted.

In the body of a pregnant woman, a single organ experiences even greater stress due to the increased volume of fluid in the body. Accordingly, the organ filters more fluid and excretes more urine.

Monitoring the entire pregnancy is very important, since chronic renal failure can occur at any time. During a normal pregnancy, a woman with one kidney does not experience a significant increase in protein in the urine and urinary disorders.

It does not matter which kidney remains (right or left). However, this statement is relative, since in pregnant women with both kidneys, complications most often arise in the right organ and ureter.

Double kidney

Duplication of urinary organs is one of the most common anomalies of the urinary system; it is found on the section in 3-4% of cases. In the clinic, it occurs less frequently - 1: 30. According to our data, the ratio between right-sided, left-sided and bilateral doubling is 4: 2: 1, and this anomaly is more often observed in girls than in boys - 2: 1.

Duplication of urinary organs can be combined with almost all other anomalies of the genitourinary system. According to our data, a horseshoe kidney with duplication of one of its halves was observed in 2 patients, hypoplasia of both halves - in 3, ectopia of the ureteral orifice of the upper part of the double kidney - in 2, hydronephrosis of both halves of the double kidney - in 3, hydronephrosis of the upper part - in 4 , ureterocele - in 1, megaureter - in 7, including with ureteral reflux - in 5; in addition, 1 girl had bladder exstrophy, and 1 boy had bladder neck contracture. Hydronephrosis of the contralateral kidney was observed in 5 patients, ileal dystopia in 1 patient, and ureteral reflux in 3 patients. In total, this amounts to 38 observations, or 22.4%. Thus, according to our data, every fifth child with duplication of urinary organs also has some other anomaly.

A double kidney is a quantitative abnormality of the kidneys, as evidenced by the amount of parenchyma, the shape of the pelvis, ureter and, finally, the volume and weight of the kidney; a doubled kidney weighs 20-25% more than usual.

There are three types of this anomaly: kidney duplication (complete, incomplete), urinary tract duplication without kidney duplication (complete, incomplete), and a combination of kidney and urinary tract duplication.

With incomplete doubling, the parenchymal part of the kidney is elongated; between the ends of the kidney, closer to the upper, there is a dividing groove. Each part of the kidney has its own artery, usually originating from the aorta. The caliber of the arteries corresponds to the mass it vascularizes. There are also two veins, their caliber is larger than the arteries, they flow into the inferior vena cava. There is only one pyelocalyceal system, common to both parts of the kidney; one ureter emerges from the renal pelvis. Incomplete kidney duplication, compared to other types of duplication, is rare. We observed such an anomaly in 6 cases out of 147 doublings (4.1%).

In most cases, complete doubling of the kidney is observed: each part of the doubled kidney has its own cups and pelvis, each of which has its own ureter. Two ureters, running parallel to each other, merge at some distance from the kidney and flow into the bladder, forming one opening. At the junction of the two ureters, there is often a narrowing, as a result of which there is some disturbance in the outflow of urine, especially from the upper part of the kidney, since its ureter forms an acute angle when it flows into the ureter of the lower part of the kidney - therefore, hydronephrosis is more often observed in the upper part of the kidney.

Sometimes the ureters do not merge, but, crossing each other, reach the wall of the bladder and open into it with two separate openings. In this case, the ureteric opening of the upper part of the kidney is lower, and the lower part is higher - the so-called Weigerg-Meyer law.

The presence of two ureters of normal length is called complete duplication of the urinary tract.

Finally, there is duplication of the urinary tract without duplication of the renal parenchyma, when there is no dividing groove between the parts of the kidney and, most importantly, there is only one set of vessels.

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In medicine, “compensation” is the restoration of disturbed balance. Compensation can be complete or temporary, depending on the degree and size of organ damage and the age of the child.

There is a lively discussion in the literature about the mechanisms and patterns of development of compensatory processes in the event of damage or surgical removal of a part of an organ or one of the paired organs, as well as the birth of a child with agenesis of one of the paired organs (kidneys). It is believed that in children, especially young children, these processes occur at a higher level than in adults.

Compensation seems to stabilize a new level of morphological and functional state. However, it does not continue throughout a person's life, so at least two factors must be taken into account in children. Unlike an adult, a child faces a longer life with an operated or only organ. During the period of rapid development of the child’s body, a huge load falls on the remaining functioning organ.

It is recommended to distinguish between 3 compensation periods: the first - 14-15 years; the second is adolescence; the third is the adult state.

At each of these periods, significant changes occur both in the child’s only paired organ and in the body as a whole. Naturally, the compensatory processes that arose in a single organ in childhood have their own patterns throughout all three periods, in contrast to those compensatory processes in the single kidney of an adult, whose body has finally formed.

With agenesis of one of the kidneys, already in the prenatal period, compensatory processes develop in the only kidney, and after the birth of the child, these processes continue in other organs: skin, lungs, liver, etc. In other words, the compensation mechanism is laid down in the earliest stages of the child’s life .

Other conditions for compensation arise in a growing child’s body during various periods of its development, when, due to injury or a pathological process, the patient is left with a single kidney. The assessment of the course of these compensatory processes and their regulation are not the same.

Naturally, the pathological process in a single organ must also be taken into account. It is necessary to agree with the statement of the majority of urologists who claim that nephrectomy is not a physiological operation, since a tense state and constant depletion of its energy arise for a long time in the functional activity of the remaining kidney.

The mechanism of compensation of renal function is multifaceted; experimental and clinical works of many authors are devoted to it. However, there is no consensus on the preservation of kidney function. Some researchers argue that compensation for the lost functions of a single kidney gradually leads to degenerative changes in hypertrophied nephrons. Others believe that a single kidney, due to reserve nephrons and hypertrophy of the organ, relatively quickly copes with the new functional regime.

It has been established that in adults, i.e., in a single organ that is already fully formed, the compensation process occurs due only to hyperplasia of the glomerular apparatus.

This process is absent in the tubular apparatus. In children, the so-called reserve nephrons play an important role in compensation at the first stage, thanks to which the functional parameters of the solitary kidney are stabilized. However, this element of compensation gradually disappears, therefore, in the subsequent years of growth and development of the child’s body, one can count, as in adult patients, only on nephron hypertrophy. This is one of the stages of the adaptive-compensatory process, confirmed by morphological studies. In clinical settings, this is confirmed by an increase in renal parenchyma.

Compensation for kidney function also occurs by increasing the speed of blood flow through the kidney. The study of the angioarchitecture of the only congenital or the only kidney remaining after nephrectomy indicates that the increased influx to the glomerular vessels contributes to an increase in intracapillary pressure in them and a sharp activation of the filtration capacity of the kidney. At the same time, increased blood circulation in the remaining kidney after removal of the contralateral kidney promotes shunting of blood flow: excess blood flows into the regulating intrarenal circulation - the extraglomerular and juxtamedullary pathways. In this regard, the blood supply to the tubules deteriorates, which explains the slow increase in their secretory-reabsorption function. In turn, the morphological transformation of the preserved arteriolo-capillary system depends on the presence or absence of pathological changes in the solitary kidney.

These morphological data are confirmed in clinical studies. Thus, when comparing the glomerular filtration of a single healthy kidney and a single kidney affected by pyelonephritis, during the first 2 weeks of the postoperative period in children with a single healthy kidney, glomerular filtration is 89.95 ± 7.6 ml/min, and with pyelonephritis - 62. 04±0.3 ml/min. The level of glomerular filtration in patients with a single kidney affected by pyelonephritis tends to decrease compared to preoperative data.

When studying the function of the tubules by determining the maximum osmolarity of urine in the active nephrons, a pronounced osmotic concentration was noted in the single kidney affected by pyelonephritis, compared with a healthy single kidney, in which the enhancement of tubular function occurs gradually. 1/2-3 years after the contralateral kidney was removed, glomerular filtration in children with a single kidney affected by pyelonephritis tends to increase osmotic concentration, reaching preoperative data. During these periods, the function of the tubules remains at the same high level as in the first days after surgery. After 5-7 years, glomerular filtration remains at the same level, and tubular function tends to decrease, especially if the remaining kidney is affected by pyelonephritis. In these patients, the percentage with renal hypertension increases; cutaneous and pulmonary water losses increase. Radionuclide studies revealed that the secretory function of the remaining kidney does not compensate for the secretory function of both kidneys.

Features of compensation of the tubular system in a single kidney (after removal of the contralateral one), especially when it is affected by pyelonephritis, are confirmed by its morphological changes. As the pathological process develops, changes in the arteries and capillaries of this organ increase: a blood depot appears in a significant number of glomeruli, blood flow slows down, intracapsular pressure increases, and the death of glomeruli occurs with the development of connective tissue in the kidney parenchyma. Metabolic processes in tubular cells weaken, the enzymatic process is disrupted in children and adults.

The degree of functional ability of the kidney in children is influenced by: 1) age at which nephrectomy was performed; 2) the nature of the pathological process in the removed kidney; 3) the degree of expression of compensatory mechanisms in the remaining kidney at the time of surgery; 4) the presence or absence of a pathological process in the remaining kidney.

A sharp decrease or complete absence of kidney function over a long period of time negatively affects adaptation mechanisms in the contralateral kidney. The degree of compensation of the remaining kidney after removal of the contralateral one largely depends on the timing of this operation. The most complete compensation is observed in children with a congenital single kidney. In adult patients, the compensatory process in the kidney depends on the presence or absence of pyelonephritis.

The rapid growth of a child's body places increased demands on the only functioning kidney. Maximum mobilization of reserve capabilities occurs, which eliminates periodic nephron quiescence. Gradually, “fatigue” of the kidney function sets in, with possible subsequent significant impairment of its function. When a pathological process occurs in a single kidney, the entire body and primarily the skin, liver and lungs participate in the compensatory process.

This position is confirmed in the works of many clinicians. Stabilization of the functional capabilities of a single kidney lasts no more than 10 years; in subsequent periods, it gradually deteriorates: after 10-15 years - by 50%, and in later periods - by 60% or more. This clinical conclusion is based on radionuclide methods and morphological studies. Taking into account the peculiarities of the course of compensatory processes in a solitary kidney in children, the phase of development of these processes should choose both the type of anesthesia and surgical tactics if surgical correction is necessary on a solitary kidney.

All children with a solitary kidney, both in childhood and in adulthood, must be under constant supervision: every year it is necessary to conduct comprehensive studies with the appointment of appropriate corrective therapy aimed at stabilizing the function of the solitary kidney, normalizing blood pressure and eliminating inflammatory processes in the upper and lower abdomen. lower urinary tract.

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Complications during pregnancy

During pregnancy, due to the increased load on all organs and decreased immunity, complications are possible both in women with two kidneys and in those who have undergone nephretomy or were born with agenesis. The most common complications are:

Infections: pyelonephritis. This complication occurs in 50% of pregnant women. Fortunately, the functional abilities of a single kidney, as a rule, do not decrease. But if past unilateral pyelonephritis became the reason for nephrectomy, the risk of its occurrence on a healthy organ during pregnancy increases even more.
Late toxicosis, or gestosis. This complication occurs in pregnant women with one kidney with a significantly higher frequency than in those who give birth with two. Preeclampsia is manifested by increased blood pressure, edema, and increased protein content in the urine. Under the supervision of a doctor, in 50% of cases, gestosis does not become severe and allows you to give birth to a healthy baby without serious consequences for the mother’s health. In the remaining 50% of cases, gestosis becomes the cause of intrauterine infection or insufficient body weight, which can later be cured. The risk of death of a newborn from gestosis in women with one kidney is not much higher.
Pregnant women with nephrectomy, the cause of which was tuberculosis, kidney stones, or a purulent process, feel even better after removal, since the source of infection is no longer present in the body, and the performance of functions is easier.
Expectant mothers who have had a nephrectomy due to unilateral hydronephrosis (dilated renal pelvis, partially atrophied renal medulla and, as a result, renal failure) have a high chance of a successful birth if the remaining organ functions well.
Women with nephrectomy due to unilateral pyelonephritis can give birth to a healthy child without complications during childbirth and pregnancy. If purulent lesions have formed in the remaining kidney, then the risk of various complications increases significantly. However, proper treatment will increase the chances of success.
Serious complications of pregnancy and childbirth can be caused by a single kidney affected by tuberculosis. Often after nephrectomy, foci of infection are observed first in the bladder, and then in the previously healthy organ. It is necessary to conduct diagnostic studies over several years, since renal tuberculosis is characterized by frequent relapses.
The prognosis is also favorable during pregnancy with one kidney, if nephrectomy was performed due to kidney stones that did not cause complications on the remaining healthy organ.
Complications of pregnancy and childbirth occur more often in pregnant women with one kidney due to nephrectomy for renal cystosis. Doctor's permission to continue pregnancy is given on an individual basis.
Complications during pregnancy appear in women born with unilateral agenesis if the only kidney cannot fully adapt to working for two. Clinical data indicate that such mothers are more likely to give birth to children with improperly developed organs of the genitourinary system. Also, in such a situation, there is a higher risk of pyelonephritis, and in the worst case, intrauterine fetal death.
A negative prognosis is given to pregnant women with one kidney due to a tumor on the other. A initially healthy organ can have metastases without showing significant symptoms. In such cases, pregnancy is either prohibited or allowed after a certain time.

Free consultation with a urologist

The kidneys perform many functions in the body. The kidneys filter waste and excess fluid from the blood, maintain the electrolyte balance of the blood (regulate sodium, phosphorus, calcium and potassium), participate in the regulation of blood pressure, and produce hormones that are necessary to maintain healthy blood and bones.

Most people have two kidneys, one on each side of the spine just below the rib cage. Each kidney, about the size of a fist, contains about one million nephrons. A nephron is a structural unit of the kidney, which consists of a microscopic glomerulus and tubules, where the process of filtering waste from the blood occurs, which then enters the collecting ducts of the urinary system.

A person may have a single kidney for one of three main reasons.

A person may be born with only one kidney, a condition known as renal agenesis. Kidney dysplasia or other birth defects make one kidney unable to function normally. Many people with renal agenesis or renal dysplasia live normal, fulfilling lives and only discover that they are living with one kidney—or one functioning kidney—when tested for other reasons.

Some people have one kidney removed to treat kidney cancer, kidney injury, or another condition. The surgery to remove a kidney is called a nephrectomy.

A large number of people donate a single kidney for transplant to a family member with end-stage renal failure.

The kidneys remove waste and excess water from the blood to form urine. Urine flows from the kidneys through the ureters to the bladder.

Most people with a solitary kidney live normal, healthy lives. Precautions must be taken to preserve the function of the solitary kidney.

What are the possible effects of a solitary kidney?

Changes that may be associated with a solitary kidney include the following:

Increased blood pressure

Proteinuria.

The presence of protein in the urine, called proteinuria, is a sign of kidney disease. People often have protein in their urine after living with a single kidney for several years.

Decreased glomerular filtration rate (GFR).

Glomerular filtration rate (GFR) measures how efficiently your kidneys remove waste from your blood. People with a solitary kidney have a decreased glomerular filtration rate.

In the nephron, tiny blood vessels intertwine with urine-collecting tubes. Each kidney contains approximately 1 million nephrons.

You can have high blood pressure, proteinuria, and decreased GFR and still feel fine. As long as these conditions are under control, they probably do not threaten your health or life. Visit your doctor regularly to monitor these changes.

How can you protect your kidneys?

Doctor's supervision

Your doctor monitors your kidney function by measuring your blood pressure and ordering blood and urine tests once a year.

Normal blood pressure is 120/80 mmHg. or lower. You have high blood pressure if, when measured, it is above 140/90 mmHg. Patients with kidney disease or a solitary kidney should keep their blood pressure below 130/80 mmHg. Controlling your blood pressure is very important because high blood pressure can damage your kidneys.

To detect protein in your urine, your doctor may use a strip of special paper that is placed in a small cup of your urine. The color of the test strip indicates the presence or absence of protein in the urine. A more sensitive test for protein in the urine (proteinuria) is done in a laboratory and the protein to creatinine ratio is calculated. A high protein to creatinine ratio in the urine (above 30 milligrams of albumin per gram of creatinine) indicates that protein is being lost that should remain in the blood.

Previously, measuring GFR required contrast material to be injected into the bloodstream, followed by a 24-hour urine collection (24-hour urinalysis) to measure how much contrast material the kidneys filtered during that time. Currently, GFR is measured in another way, which is based on calculating the amount of creatinine in a small amount of blood. The new method of calculating GFR uses a special formula that takes into account the patient's creatinine level, weight, age, sex and race. Some laboratories calculate GFR at the same time as testing blood creatinine levels. If your glomerular filtration rate is below 60, you have chronic kidney disease.

Blood pressure control

If your blood pressure is higher than normal, you should work with your doctor to find treatment to keep your blood pressure no higher than 130/80 mmHg. For patients with a single kidney, it is necessary to carefully select medications that lower blood pressure. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers are two classes of blood pressure-lowering medications that protect the kidney and reduce proteinuria. However, with renal artery stenosis, that is, with a narrowing of the artery supplying the kidney, these medications are contraindicated. Diuretics can also lower blood pressure by reducing blood volume. Treatment of high blood pressure may require a combination of two or more medications, in addition to changes in diet and lifestyle.

Diet

Having a single kidney does not mean that you have to follow a special diet. You just have to eat right, including fruits, vegetables, grains and low-fat dairy products in your diet. Limit your daily salt (sodium) intake to 2 grams or less if you have high blood pressure. Pay attention to the amount of sodium written on food labels, and also keep a diary of your salt intake. Limit alcohol and coffee. Avoid protein-rich diets. In the body, protein breaks down into breakdown products, waste products that the kidneys must remove, thus, a large amount of protein in food puts additional stress on the kidneys. Proper nutrition requires consuming a moderate amount of protein. A nutritionist will help you determine the required amount of protein that should come from food.

Injury Prevention

Some doctors advise patients with a solitary kidney to avoid contact sports such as boxing, hockey and football. One study found that motor vehicle accidents and falls from bicycles cause more serious kidney damage than sports events. In recent years, athletes with only a working kidney have been participating in sporting competitions at the highest level. Having a single kidney does not automatically exclude you from playing sports. Children should be encouraged to play sports, even if contact sports are prohibited. Special protective equipment, such as extra vests under uniforms, removes restrictions on the activities of basketball or football for patients with a solitary kidney. Doctors, parents and patients with a solitary kidney must evaluate the risk of any activity to make the right decision.

The article is for informational purposes only. For any health problems, do not self-diagnose and consult a doctor!

Author:

V.A. Shaderkina is a urologist, oncologist, scientific editor of Uroweb.ru. Chairman of the Association of Medical Journalists.

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Is it possible for a woman to give birth with one kidney: rules and recommendations

The kidney is a paired organ, weighing about 120 - 200 g each . Performs a number of functions necessary for the human body. The main job is urine filtration. Thanks to this organ, the blood plasma is cleared of toxic waste products, which are then excreted in the urine.

Every day, the kidneys of an adult pass 1,700 liters of blood , filtering about 1.5 liters of urine . In a number of diseases, the filtration capacity of the organ decreases, and renal failure develops.

Decay products poison the human body. Without treatment, the person will eventually die. If it is impossible to restore the lost function, chronic hemodialysis is prescribed followed by kidney transplantation.

Symptoms of the absence of one kidney

the child looks unhealthy;
external signs: wide and flat nose, slightly overhanging forehead, increased interocular distance, underdeveloped upper jaw, severe folding of the skin, deformation of the legs, increased abdominal volume;
reduced lung size;
swelling of the face;
incorrect structure of the genitourinary system, when one kidney is present from birth. For example, boys do not have a duct for removing seminal fluid, and both sexes do not have a ureter;
presence of sexual dysfunction in men, pain during ejaculation;
soreness in the groin and sacrum areas.

Often children with one kidney are born prematurely, their healthy organ is enlarged in size. If the kidney is working normally, then the above symptoms may not be observed.

Definition of "single kidney"

This refers not only to the absence of an organ, but also to loss of function due to a number of diseases.

A kidney may be absent due to:

Congenital malformation – agenesis.
Surgical removal - nephrectomy.

Diseases leading to disabling the function:

Pyelonephritis.
Urolithiasis disease.
Hydronephrosis.
Injuries.
Tumors.
Tuberculosis.
Renovascular hypertension.
Giant cysts.

Recently, thanks to the development of transplantation, there are more and more young women with a single donor kidney who want to get pregnant.

Why is there only one kidney?

1. Congenital pathology - renal agenesis, when one of the paired organs is completely absent and dysplasia, when the second organ is present, but its development and functioning does not occur.

2. Removal of a kidney through surgery - in case of certain diseases of the organ (cancer, polycystic disease, tuberculosis, pyelonephritis, etc.) and injuries, which excludes the possibility of further normal functioning of the kidney.

3.Organ donation for transplantation.

Adaptation to normal life takes a minimum of time in a newborn with one kidney, while this period after removal of the organ lasts from 6 months to 2 years.

Planning pregnancy: contraindications, precautions

Childbirth is possible in most cases . The patient’s age, nature and history of the disease, and treatment results are taken into account. If nephrectomy was performed, the course of the operation and recovery period is of no small importance. Much depends on the initial diagnosis.

It is not recommended to become pregnant:

After kidney removal due to cancer. Due to hormonal changes in the body, the risk of disease relapse and late metastasis increases.
After nephrectomy for tuberculosis, the full course of treatment with antibacterial drugs has not yet been completed. They negatively affect the fetus.

When deciding to become pregnant, the patient is primarily responsible for her health. Pregnancy in women with a single kidney is prohibited in the presence of pyelonephritis and renovascular hypertension.

Possible complications of the gestational period with these diseases:

Severe gestosis.
Acute or chronic renal failure.
Malignant arterial hypertension.
Stroke.
Infection, malnutrition, fetal malformations.
Intrauterine fetal death, spontaneous termination of pregnancy.
Death of mother.

The course of pregnancy will be more favorable after removal of the organ due to pyonephrosis, tuberculosis (subject to completion of the course of treatment), and urolithiasis than before the operation. A kidney with a huge cyst does not function; its absence does not impair the functioning of the urinary system at any stage of gestation.

With a congenital malformation - a single ectopic kidney, pregnancy becomes a serious burden on the excretory organs.

The daily filtration process is joined by the removal of fetal waste products entering the mother’s body via the transplacental route. But, nevertheless, successful pregnancy and childbirth are possible.

The most optimal period for pregnancy is the second to fourth year after nephrectomy . This is the time the body needs to adapt and fully restore the functionality of the urinary system. For approximately two years, the single kidney is rebuilt to work with double load.

Clinical manifestations of the anomaly

Basically, children with congenital pathology are born prematurely. If an abnormality is not detected on an ultrasound, it will appear within a short period of time after birth, but sometimes it takes years to diagnose this defect.

When the only kidney in a newly born child cannot cope with the increased load, the child, even in the initial period of life, suffers from frequent urination and dehydration. A child with one kidney exhibits characteristic symptoms:

sickly appearance;
swelling of the face;
high blood pressure;
serious intoxication.

The manifestation of such an anomaly as the presence of one kidney occurs differently in boys and girls. In the fairer sex, a concomitant phenomenon is often an anomaly in the structure of the uterus and significant underdevelopment of the vagina. The structure of the male body assumes a direct connection between the kidneys and the genitals.

In this variant, there is often no duct responsible for the removal of seminal fluid, and dysfunction of the seminal vesicles is also observed. Characteristic clinical signs can also be observed in the case where the ureter is not formed due to the absence of one kidney. All these shortcomings can lead to pain in men.

In addition to the abnormalities that were inherent in the womb, children with a single kidney may have a number of renal abnormalities, such as urolithiasis, etc. Unfortunately, such diseases can give rise to the phenomenon of renal failure, which is absolutely inconsistent with this pathology.

It is very important not to miss the anomaly, make a timely diagnosis, and closely monitor the development of the newborn. Any injury or viral infection can greatly harm a child's health.

If a child was born with one kidney, and it immediately began to cope with the increased load, then such a deviation is not easy to detect, it does not manifest itself externally and parents, naturally, do not notice the problem. But if after the birth of the baby specific symptoms are visible, it is necessary to urgently conduct laboratory tests, in combination with an ultrasound.

MRI also provides a good diagnostic picture, and at later stages of development. After all, when a child has a healthy kidney, ultrasound does not always reveal an anomaly. But the doctor observes not only the fetus itself, but also notices changes in the amniotic fluid. An experienced specialist, having assessed their condition, is able to draw a conclusion about an abnormal pathology. The sooner the doctor can detect the problem, the more effective the treatment will be.

Rules and recommendations

To avoid possible complications, the expectant mother should be regularly monitored by an obstetrician-gynecologist, nephrologist or urologist and, if indicated, other specialists. General clinical blood and urine tests are regularly examined (at least once every 2 weeks), blood biochemistry according to the renal program, and if necessary, additional examination methods are prescribed.

Basic recommendations for pregnant women with one kidney:

Healthy lifestyle: adherence to work and rest schedule,

a full night's sleep, complete abandonment of bad habits.

Sufficient physical activity: swimming, gymnastics for pregnant women, walking.
Diet with limited hot, spicy, salty foods;
Adequate water load.

If the function of a single kidney is impaired or a disease occurs, a doctor will help you decide on expanding your diet, prescribing herbal infusions and medications. Under no circumstances should you self-medicate!

Reasons for the absence of an organ

Most people living with one kidney do not even realize that they have only one organ from birth. This phenomenon is diagnosed, as a rule, during an ultrasound examination of internal organs, either based on complaints or during a routine medical examination necessary for professional activities. However, there are other reasons for the absence of one of the paired organs.

Congenital anomalies

Attention! From approximately the 3rd to the 10th week of pregnancy, the developing kidneys gradually rise to the level of the lumbar spine. During this period, it is extremely important for a pregnant woman to avoid toxic effects on the body (including alcohol and tobacco), stress, viral and infectious diseases.

Any substances, even conditionally dangerous ones, can cause irreversible changes and mutations in the development of the baby. These substances, recently, also include personal hygiene products, dyes, flavor enhancers, genetically modified food products, and factors that also have an impact: polluted environment, medications, bad habits. As a result of the complex effect on the body of these root causes, anomalies in the development of internal organs in the fetus may occur, in particular, renal anomalies include:

Agenesis. Congenital absence of one kidney, which was not formed during the embryonic period under the influence of various factors;
Aplasia. One of the paired organs has not formed properly, the structure of the pyelocaliceal system is not formed, there is no ureter. Over time, an organ that does not perform its function becomes overgrown with connective tissue. That is, in fact, only one kidney works throughout your life;
Multicystic kidney disease. Due to functional inferiority, the kidney, over time, the renal tissue begins to turn into cystic formations in the form of sacs with contents. If, over time, the cysts in the affected kidney are not replaced by connective tissue, then such an organ most often has to be removed.

Most often, these congenital pathologies are diagnosed during ultrasound examination. In this regard, it is worth noting that children with anomalies in the form of aplasia, multicystic disease or agenesis of two kidneys at once are either born dead or die in the first day of life.

Loss of a kidney during life

The reason for removing one of the paired organs is either removal of the kidney during treatment of the disease, or donation. In this context, it is worth understanding that one kidney is a disability only if there is kidney disease. Related organ transplants are not performed from unhealthy people, so kidney transplants usually do not provide disability.

In the case of an operation to remove a paired organ (nephrectomy), which is performed according to indications due to a severe disease of the urinary organ, we can talk about a potential risk for the remaining healthy organ when conservative drug treatment does not bring positive results. The most common reasons for removal are:

Tumor formations;
Trauma that disrupts the functionality of an organ, with destruction of the parenchyma;
Kidney failure.

SPECIAL WOMAN: Is pregnancy possible with one kidney?

The mere thought of the absence of a kidney (kidney disease) usually terrifies a woman (especially those planning a pregnancy). A huge number of myths scare about complications and the inability to get pregnant and give birth to a child. But not everything is as scary as it seems. Elena BEREZOVSKAYA, a doctor-researcher, obstetrician-gynecologist, founder and director of the International Academy of Healthy Life (Toronto, Canada), speaks about this. EtCetera continues to ask the doctor important questions about women's health.

Etcetera: Are there global statistics on how many women with one kidney or problematic two kidneys give birth?

Elena BEREZOVSKAYA: We can divide all women who have one kidney into several groups. The first is women with congenital pathologies or diseases. The second is those who donated their kidneys, which is now not uncommon in the EU and North America.

The study showed that women with one kidney become pregnant no less often than those with two, despite the fact that there is a certain risk. Approximately 60% of such women become pregnant and even give birth to two or three children.

Etcetera: What risks exist in such a situation for the woman and for the child?

Elena BEREZOVSKAYA: There may be detachment during pregnancy. The load on the kidneys, which filter more urine, increases, and the woman may experience complications. A disease such as hypertension in pregnant women develops more often, and it is here that the renal factor plays an important role. This condition is less treatable. Such women are almost 2.5 times more likely to experience a complication such as complication. Women with one kidney are also more likely to have gestational diabetes. And such women are more likely to give birth prematurely. There are no serious abnormalities observed on the part of the fetus.

Etcetera: Can these complications be considered so critical as to advise against pregnancy?

Elena BEREZOVSKAYA: In percentage terms, these complications are not so frequent as to manipulate them and recommend refusal of pregnancy. Typically, such a woman should be managed by a specialist doctor - for example, a nephrologist. Because they usually increase the amount of protein, sugar, and acetone. And here it is very important to distinguish complications in the form of increasing functional kidney failure from the usual phenomena that occur during pregnancy.

Etcetera: What are your recommendations for those who have kidney problems or became a donor, but decided to have a child?

Elena BEREZOVSKAYA: If a woman with one kidney is planning a pregnancy, then we always recommend determining what diagnosis accompanies this process - a healthy donor woman or a woman with diseased kidneys.

Next, a woman with kidney problems must undergo thorough examinations (kidney tests) in order to cope with the stress of pregnancy.

For female donors, it is necessary to determine how the kidney works and whether all functions are normal. And during pregnancy, the treatment will be determined by the doctor - depending on what happens during pregnancy.

RESULT

It is reliably known that one kidney can perform the functions of both by 75% - this is ensured by the high compensatory abilities of this organ. Therefore, in general, one kidney is not a contraindication for pregnancy, concluded Dr. Elena Berezovskaya. And most women give birth on their own—the presence of one kidney most often does not require surgical delivery. The exception is when there is actually a violation of kidney function.

The kidney survived

I underwent disgusting urine tests under the supervision of doctors for 20 weeks. She delayed it as best she could so that the baby was fully formed.

And my gynecologist shouted: “He already has five fingers!” There can be no complications! It is formed!

And I started taking antibiotics. Literally on the second day, my cloudy urine began to lighten and acquire a healthy color. On the fourth day I was on antibiotics.

And again my nephrologist saved me - she prescribed me a completely harmless medicine, thanks to which the allergy did not recur, and the course of antibiotics was completely consumed.

There were other problems during the second pregnancy, but they had nothing to do with the kidneys. The tests were perfect until the end of pregnancy.

And again by week 37 the swelling and pressure are strong. Exactly at 37 weeks, my water broke... Apparently, my body could no longer withstand the load. I gave birth myself. The birth was easier than the first time.

Reasons for such an anomaly

There is no main reason for this deviation. Parents may not even suspect that their child is ill, because he develops in the same way as other babies. Perhaps genetic predisposition played a role in the body. Such a special baby can be born to a mother who suffered from infectious diseases during pregnancy.

This anomaly is called agenesis, it is divided into 2 types:

Bilateral kidney damage. As a rule, a child dies in the womb or after birth, having lived for several hours.
Unilateral agenesis. In this case, one of the kidneys retains its viability and takes over all functions.

Doctors say that agenesis with the right functioning kidney is more common in women. Most likely, this is due to the physiological characteristics of the structure of the body. If the remaining organ fails to cope with its responsibilities, then the person, as a rule, receives the status of disabled person.

If the deviations are minor, then such people are not given a disability. But still, if a child was born with one kidney, then he is no longer like everyone else. Despite their good health, such children or adults must undergo a full medical examination or have their blood and urine tested once a year.

If necessary, modern medicine can offer donor organ transplantation. If the operation is successful, the new organ will function.

Complications and contraindications

Patients' concerns are associated only with kidney pathologies. After all, they have only one organ, so attention to its condition is doubled. The most dangerous manifestations of agenesis are:

Urinary dysfunction. The volume of urine may decrease or even be completely absent.
Renal colic is an attack of pain accompanied by urination problems.
High blood pressure that cannot be treated with conventional medications. Indicators can reach very high numbers.

If the above manifestations occur, you should immediately contact a nephrologist. If there are no such violations, then it is necessary to conduct an examination at least once a year and take urine and blood tests. The doctor can give different recommendations for each patient individually.

Life after nephrectomy

Sometimes one of the two kidneys has to be removed. This operation is called nephrectomy. In this case, a person can also lead a full life, with the exception of some restrictions. In the postoperative period, rest and bed rest are necessary. All food should be gentle.

The remaining kidney will increase slightly in volume, which will be accompanied by slight discomfort, which will pass over time. After nephrectomy, a person should adhere to gentle physical activity and carry out hardening procedures.

Food should be high in calories, but easy to digest. Preference should be given to:

Dishes of vegetables and fruits.
Rye bread.
Fermented milk products.
Dishes made from lean meat or fish.

Fatty, canned, and spicy foods can be consumed in limited quantities. Maintain drinking regime. Sharp restriction of fluid and salt is undesirable.

How is pregnancy progressing?

The complexity of pregnancy and subsequent childbirth depends on the general condition of the expectant mother’s body.
Doctors say that the removal of one organ is not an obstacle to the normal course of pregnancy.

Even despite the increase in the amount of blood passed through, one kidney can cope with this load. An increase in the functional load on one kidney does not occur immediately.

Full restoration of the organ’s functioning occurs in approximately 2 years. It is not recommended to plan a pregnancy before this period.

For a favorable course of pregnancy and successful childbirth, it is necessary to regularly undergo the necessary tests throughout the entire period and be observed by a nephrologist.

If the kidney copes with its load, then the tests will not go beyond normal limits.

The appearance of protein in the urine signals the occurrence of complications.

Preventive measures

If a person knows that he has been missing 1 kidney since birth or has had a nephrectomy, then his lifestyle may be somewhat different from other people. Although preventive measures will not hurt everyone else, as they provide recommendations for maintaining general health:

Infectious diseases should be prevented.
In the presence of chronic ailments, promptly eliminate the source of inflammation.
Avoid hypothermia of the body.
Periodically visit a urologist to monitor kidney function.

In general, we can say that the life of a person with one kidney is not much different from the life of other people. Many young women are concerned about how they will be able to give birth to a child with one kidney, and whether this is acceptable.

There are many examples of such women giving birth to completely healthy babies. This circumstance is not a contraindication for childbirth. In medical practice, of course, there are cases of unsuccessful pregnancies in women with one kidney; it all depends on the characteristics of each specific situation.

What to do if your right kidney hurts and what these symptoms indicate

The modern world is a rapid cycle of affairs, worries, stress and much more.

Naturally, a person with such a rhythm of life is not immune from the occurrence of various diseases. The disease can manifest itself in any of the internal organs, and the kidneys are no exception.

Particular attention should be paid to the right side. It is the right kidney that hurts most often.

This is due to the fact that the right kidney is located slightly lower than the left. Thus, stagnation of urine is possible in it and, as a result, the proliferation of microorganisms that cause inflammation of the organ.

A short excursion into anatomy

The kidneys are located on the back wall of the abdominal cavity on either side of the spinal column.

As mentioned above, the right organ is located 1.5 - 3 cm lower than the left kidney.

This is due to the fact that most of the right side of the abdomen is occupied by the liver, where appendicitis is also located. All these factors contribute to the fact that the right side is different from the left.

The buds are bean-shaped. Kidney tissue (parenchyma) does not have nerve endings, so the surface cannot hurt.

It's just that your kidney won't hurt

The reasons why the kidney on the right side hurts can be very different, below is a list of the most possible:

The most common cause may be inflammation of appendicitis. Sometimes it is not in the place where it is generally believed. This inflamed appendage causes pain in the back area.
If the ligaments are insufficiently strong, nephroptosis is possible. This displacement of the kidney is mostly common in women.
During pregnancy, when the uterus increases in size and moves to the right side, pressure occurs on the venous system. This may be the cause of inflammation, which is called right-sided pyelonephritis.
The right organ is more susceptible to diseases such as urolithiasis (urolithiasis).
A kidney cyst may be a cause of acute pain.
All kinds of injuries.
Tumor, cancer. These can be benign tumors - fibroids, adenomas and fibriomas.
All kinds of complications of urolithiasis and pyelonephritis, in which organ tissue is destroyed.
Deformation of the kidney due to secondary or congenital hydronephrosis, where pain may result from an atrophying part of the calyx or pelvis of the organ.
Purulent formations - abscess or carbuncle.
With advanced nephroptosis, ischemia is possible.
Diseases of the veins and arteries of the kidneys (stenosis).
Development of parasites in the organ.

There are many symptoms that accompany pain in the right kidney, some have a similar nature of occurrence and sensation, but to accurately determine the causes, you should contact a urologist.

The nature of pain indicating kidney problems

A person experiences different pain sensations throughout his life, but often confuses the cause. Lower back pain on the right side can indicate many problems and not necessarily the kidneys.

Below is a list of symptoms that accompany pain in the right kidney and which indicate a problem with a person's "little filters":

nagging and aching pain in the lower back;
colic on the right side extending to the groin;
blood appearing in the urine;
characteristic pain that may disappear when changing body position to a vertical position;
pain impulse in the abdomen, radiating to the lower back;
pain when urinating, which may be accompanied by heaviness in the right side of the back;
skin itching;
Often with kidney disease, the color, smell and composition of urine changes.

Pregnancy is not only joy, but also responsibility

If a woman’s right kidney hurts during pregnancy, then most often this indicates chronic diseases:

pyelonephritis - the pain is not very strong, mainly in the side, it happens on both sides or more in one of them, the pain has a pressing character;
glomerulonephritis;
urolithiasis disease.

Pyelonephritis - unpleasant and dangerous

If pyelonephritis first appeared during pregnancy, it is called gestational or pyelonephritis of pregnant women.

It often develops at the end of the second trimester of pregnancy. The chronic form of the disease can also worsen, in which case the disease often occurs in an erased form.

If you have a history of illness, there is a risk of the following problems during pregnancy:

premature termination of pregnancy, this is due to the presence of pain, high temperatures, and inflammatory processes in the body during an exacerbation of the disease, all of which increases the excitability of the uterus;
gestosis is chronic edema of pregnant women, which causes spasms of the uterine vessels, insufficient oxygen supply to the fetus, and deterioration of the mother’s well-being.

Glomerulonephritis is a provoking factor of pain

Glomerulonephritis in pregnant women occurs with a frequency of 0.1% to 9%. This disease, which has an infectious-allergic origin, leads to immune damage to the glomeruli of the kidneys.

Occurs under the influence of hemolytic streptococcus. May appear after flu or sore throat.

Symptoms include puffiness under the eyes, swelling of the legs, frequent urge to urinate, and lower back pain. Against the background of this disease, surges in blood pressure are possible.

Urolithiasis disease

Urolithiasis in pregnant women occurs in 0.1-0.2% of cases. Symptoms of urolithiasis during pregnancy are manifested by pain in the right kidney, hematuria, and the passage of stones.

An exacerbation of the disease occurs unexpectedly - a sharp pain in the back in the kidney area, radiating to the groin, leg, and pit of the stomach.

Features of therapy

The choice of treatment will depend on the period at which the disease occurred. So in the first trimester of pregnancy, doctors will offer therapy with herbs and infusions, without the use of potent drugs.

If a pregnant woman is diagnosed with pyelonephritis, it is necessary to undergo treatment with antibiotics; those that will not harm the development of the child are selected.

Diuretics are also used, which have a gentle effect on the excretory system and the body as a whole.

If you discover kidney disease during pregnancy, you need to adjust your diet. Do not eat fried, salty foods, avoid sour and spicy foods.

Cranberry juice and diuretic herbs have a positive effect; they will help remove excess water and toxins from the body.

Patient diagnosis

As a rule, the first stage of diagnosis begins with examining the patient and interviewing him. The main task here is to identify the symptoms.

They depend on the time of development and form of the disease. The main signs are high temperature, swelling and dark urine.

After all examinations, the patient is prescribed to undergo laboratory tests:

A general blood test allows you to determine the possible causes of inflammation.
Biochemical blood test - shows the composition of urea and creatine in the blood. In certain cases, a search is made for antibodies, the presence of which may indicate an infectious disease.
Urinalysis - necessary to determine the amount of protein and red blood cells in the urine.
A kidney biopsy is a procedure that allows you to obtain an element of organ tissue for a more detailed study of the source of the disease.
Instrumental methods - usually ultrasound diagnostics - allow you to determine the size of the kidneys.

Based on the test results, the patient is prescribed a set of measures, medications and recommendations. In particularly dangerous and complex cases, the patient may be sent to hospital treatment.

What can be done?

For pain in the right kidney, treatment is prescribed, which depends on the cause of the disease that caused the pain.

In most cases, it is recommended to take a course of hormonal drugs or antibiotics; diuretics and medications that relieve pain and inflammation are also needed.

In addition, they are prescribed to take vitamin-mineral complexes. For kidney disease, physiotherapy and herbal medicine are indispensable.

In acute diseases that are accompanied by symptoms and factors such as renal colic, purulent discharge, blood in the urine, malignant and benign tumors, kidney stones, surgical intervention is prescribed.

Here, there are three options:

The operation is performed using a cystoscope; a plastic tube is inserted into the ureteral canal. This is done to determine the causes of diseases in which it becomes impossible to remove urine through the inflamed path.
The procedure of cutaneous nephrostomy also helps restore the outflow of urine from the kidney.
In more complex cases, nephrotomy or nephrectomy is performed.

After all operations and activities, the patient is prescribed a course of physiotherapy.

It varies in the way it works:

applications using paraffin and ozokeratin substances;
electrophoresis;
medicinal baths.

In order to prevent diseases associated with the kidneys, and therefore unpleasant pain, you should adhere to certain rules: you should not overcool the body, treat all types of inflammation in a timely manner, and do not abuse alcohol.

Recommended Diet

Diet is an important factor in the healthy and fulfilling life of such special people. The diet should be rich in foods such as sour cream, honey, eggs, vegetables and fruits.

It is better to eat boiled meat, as well as fish, and preferably rye bread. The quantity of products should be determined by an experienced nutritionist. High-calorie foods are recommended, but not protein foods.

If you decide to eat vegetarian foods, then you should not rely on legumes and pasta; it is better to replace them with potatoes or vegetables. One kidney already has a double load, so you should limit the intake of large amounts of mineral salts into the body.

They are found in canned foods, smoked foods, pickles, and carbonated drinks. Caffeine and alcohol are contraindicated; you can drink fruit drink, compote or juice. Such nutrition will not allow the only kidney to lose its functionality, otherwise you will have to register for disability.

To smoothly transition from protein foods to others, you must adhere to the following rules:

Eat boiled meat or fish, but not more than 3 times a week.
Eat foods rich in carbohydrates. This includes buckwheat, oatmeal and other porridges, rye bread; from white varieties, choose grain bread. Other baked goods are excluded or reduced to a minimum.
For dairy products, sour cream and cream are recommended. It is better to reduce the consumption of other fermented milk products.

Treatment of kidney abnormalities

When a person’s only kidney has a pathology, drug treatment is carried out according to indications, as well as surgical treatment - donor organ transplantation. In case of renal failure and while waiting for a kidney to be transplanted, if conservative treatment does not help, active therapy is prescribed, such as hemodialysis and peritoneal dialysis. The meaning of the procedure is to purify the blood using an “artificial kidney” apparatus in the first case and the introduction of a certain liquid into the blood with its subsequent removal to the outside – in the second.

For some reason, 0.05% of people are missing one kidney. Many people have no idea about this, since a full life with one kidney is quite possible, since the body quickly adapts to such living conditions, and a single organ will work for two. If a person knows about such a pathology, then he is recommended to take care of the kidney and ensure its safest functioning.

Renal agenesis in newborns

As noted above, children can be born with one kidney due to genetic predisposition. According to statistics, most often such babies can appear in mothers suffering from diabetes.

A child with one kidney is born weak and may have external defects. Treatment proceeds in 2 directions. This includes antibacterial therapy and donor organ transplantation. Sometimes, despite the high risk to the life and health of the child, a donor kidney transplant is the only correct solution for renal agenesis, especially bilateral.

If agenesis is one-sided, and no external signs of the disease are observed, then no treatment is carried out. If a violation is detected, a diet, a gentle lifestyle, and a minimum of physical activity are indicated.

Congenital absence of a kidney is not a serious disease; a person may feel completely healthy. But it is worth remembering that the organ, designed by nature as a pair, but being the only one, takes the entire load upon itself, so you should not overload it. You will have to take more careful care of your health.

Video: Kidney removal, increase iron intake

A person may have a single kidney for one of three main reasons.

Some people have one kidney removed to treat kidney cancer, kidney injury, or another condition. The surgery to remove a kidney is called a nephrectomy.

A large number of people donate a single kidney for transplant to a family member with end-stage renal failure.

Possible complications during pregnancy

The likelihood of complications occurring during pregnancy depends on the reasons for which the kidney was removed.

if a kidney is removed due to pyelonephritis, then during pregnancy the risk of developing this disease again arises;
if the reason for removal was tuberculosis, then the likelihood of recurrence of the disease during pregnancy is high;
after removal of a kidney due to hydronephrosis, a high percentage of favorable pregnancy and the natural process of childbirth;
polycystic kidney disease also often causes the removal of one of them. In this case, the chances of a successful pregnancy are 60%, because there is still a possibility of cysts occurring on the second kidney;
a previous oncological process in one of the kidneys is a direct indication to postpone pregnancy.