So which kidney did you have transplanted?

[askmeanythingkidney]

Ok, weird AIBU post and really a question for GPs and medical professionals on Mumsnet

TLDR: would you expect a Gp/medical professional to have a basic understanding that you can live happily with one kidney?

Background. I had a kidney transplant some years ago. I have since had children and am regularly seen by my nephrologist and the team.

The last couple of years (especially with pregnancies) I have had to see my GP/consultant gynaecologists/ anaesthetists etc. My transplant has always come up as part of my medical history. 9 times out of 10 I get asked questions along the lines of

-So which kidney did you have transplanted?

-Which kidney stopped working?

-Which kidney did they replace?

-Which kidney came out?

And many many similar.

Now, I would NOT expect the general population to know this but you can live a pretty normal life with just one healthy kidney. It's not uncommon to be born with just one, to have one removed for some reason etc. If you still have one kidney, then you don't need a transplant. So the answer to all of the above questions is 'eh? Both stopped working??'

I'm afraid I lost my cool a bit today over the phone with a GP who asked me if it was my left or right one that was transplanted? I said, both kidneys failed and that's why I needed a transplant. I was told, no....one of my kidneys would still be working ok, I probably just wasn't told which one they took out and transplanted.... I explained again that they don't remove a kidney when they transplant, they just add the third one in.

The GP then just got a bit frustrated and said he'd check my notes as I obviously wasn't made aware which one. I got a bit angry and said perhaps I should ask Google for help with my question as that seemed more informed than he did. Yes, totally unreasonable of me and I asked to speak to someone else who was infinitely more helpful.

So, as a Doctor or someone in the medical field, would you know that you only have a transplant if both kidneys stop working and if one still does, it negates the need for a transplant in the first place? AIBU to get frustrated with the same constant questions?

Hmmm, I've just reread it. I think maybe I am being unreasonable to expect this knowledge.

I'm just so fed up of the same question, suffering from the heat and an infection I'm trying to get treated, and the last doctor was a patronising idiot.

I think a cool shower may sort my angry rant out!!

I knew that, just from what I did in GCSE Biology, so would expect a GP to understand something that simple too. YANBU to be frustrated.

This in was a diagram in my GCSE biology textbook in the 90s (double science rather than biology). It surprises me that they don’t know as general knowledge.
However, there are several medics in my family and I’ve noticed that they aren’t always up on things outside their speciality, nor would they need to be.

YANBU I can't believe a gp wouldn't know this. I have no medical training, even I know they leave the non working kidneys in and add a third in higher up. Why would a gp ever think you replaced one. How do they think kidney donors work?

I have absolutely no personal experience of kidney transplants or any medical training but I am well aware that it is possible to live with just one. I am also aware that a living donor can donate a kidney to a suitable person who needs one and function fine on their one remaining one. So yes I am surprised that a doctor would not be aware of this.

You could print out a page from GCSE bitesize and bring it with you in case you get patronised again.

Not a doctor (which is about to be made abundantly clear...)

I always assumed that if someone has had a kidney transplant that means they have had one malfunctioning kidney and therefore need another put in so that they will once more have 2 functioning kidneys.

I was aware that a body can function with just one kidney, but hadn't realised that to have a transplant the perosn will have had one malfunctioning kidney already and had been relying on the other kidney, but that last functioning kidney will have now stopped working.

They did a live kidney transplant on channel5 a few years ago when they explained that they insert the new kidney but don’t remove the old one. In fact they said that they had done transplants for people who essentially had 4 or 5 kidneys due to transplant and then subsequent rejection.

As for her saying that you will have had one working kidney, how does she think that live donors manage with just one kidney then when they give one to a relative.

I actually would complain to PALS about this. A bit of ignorance is understandable sometimes. But this level in a medical professional is unacceptable.

I'm not a doctor but I know you can live with just one.

I've never thought about whether one or both are removed in the case of a transplant. I would have assumed one was removed.

What I do know is GPS are often not close to detail - I have eczema and when I need a new prescription for items not permitted on repeat, I tend to give a quick overview of my history which (I assume) shows I know what I'm talking about and they can see what I've had before with what frequency.

When I don't, there's a long and painful discussion. I guess they are just doing their job, but in your case it sounds odd to be so vehement when you are clearly stating something opposite.

It would be interesting to hear from some docs what they do in these situations.

Ahhh, thank you. I already feel better and more justified to be cross

Normally on threads like these you might imagine someone is exaggerating slightly but I've had cause to speak to 4 doctors over the last month and 3 of them have asked me about 'which kidney' or something else to that effect that shows no understanding of this

The doctor today who started arguing and correcting me was just the absolute worst!!

And you're right @Sweatinglikeabitch , how on earth could someone donate a kidney if you need two functioning ones to live.

How did you assume then that a person can be a live donor? Why would someone deliberately give up one kidney so that someone else could have two functioning kidneys?

I’m sorry but that logic just makes no sense what so ever.

If a person needed two kidneys then live donation wouldn’t be possible. And if a person could function on one kidney then dialysis wouldn’t be necessary.

I did not know that they don’t remove a kidney when you get a new one!
Luckily I’m not a Dr.

The annoying thing isn’t so much them asking the question as not believing the answer I think.

My partner has a kidney transplant and my god to people ask some dumb questions 🤦🏽‍♀️ totally reasonable and the GP should bloody know

Not a doctor. The failed kidneys may occasionally be removed if there is something wrong with them (infected, enlarged) but if they are not causing a problem it is more common for them to remain in place.
I only know this because I know someone that happened to.
They might just be trying to get a complete history without making assumptions.

You need a minimum of approximately 25% total kidney function in order to maintain adequate excretion. That is in total across both kidneys. It would be very unusual for one to fail entirely, and the other one to half fail; it will usually be evenly spread across both. That is how you can get away with just having one fully functional one added (or removed, if the remaining one is working well).

I only have one kidney, so I do know. My doctor once thought I was going into kidney failure as my GFR (globular filtration rate) was low. It turned out that a low reading was normal for a person with only one kidney but I spent a week really worried before the doctor realised and apologised to me.

Glomular not globular

Yes! I've also had this as technically I only have one functioning kidney. Got a text asking me to urgently call my doctors to discuss my blood results. Rang and got an appointment for the doctor to say there was an issue with my egfr and then stumble on his words as he obviously then scanned down my notes as he was talking.

So pleased I arranged childcare for that appointment!!

I am another one who is not a doctor, but knows this. B

ut I watch alot of shows like QI, so also know Pope Francis only has one lung

I know full well you can function with one kidney, but tbf I’m not sure those questions assume 2?

To me The implication is that One of the two malfunctioning ones has been replaced and they are asking which? I.e wanting to know where your working kidney is. Except ‘which kidney stopped working’.

I also knew, although I couldn't tell you how, that in general the duff kidney is left in and a new one transplanted above. I am not a medical person at all.

I have no medical qualifications and knew that you can live a normal life with just one kidney. I also know that you don't go on the transplant list unless both of your kidneys are failing (or your only remaining/functioning kidney is failing). I was also aware that they don't remove the malfunctioning kidney and just add a third.

From the wording of the questions it sounds like they might think you are a donor rather than a recipient. Do you think the wording on your records suggests that you donated a kidney rather than received one? That would mean having only one functioning kidney.

My daughter is 2 and born with only 1 working kidney so I know that can be all ok, I would also known this before otherwise how would people be a donor, I have to say I didn't know they leave the kidneys in if not working and add the donor one in.

I think that’s probably the kind of thing all doctors “know” at medical school but forget over the years as more regularly used knowledge edges the theoretical stuff out. I don’t imagine they have much cause to think too deeply about the mechanics of surgical nephrology. How many kidney transplant patients are likely to be on each surgery’s books, and how often does it crop up? It’s the horses/zebra thing at play.

FWIW, I have a (thankfully easily treated) condition that is so unusual and was diagnosed by such a newly developed test that non-specialists have never heard of it. So I know you end up repeating yourself a lot, but I don’t think it can be helped really. As long as the specialists and surgeons know their stuff!

Also not a doctor or a medical professional but I also knew you could live with only one kidney. I did not know they didn't remove the non-functioning kidneys so that's something I learned today. I would be curious though, why those questions are being asked? Presumably if they just stick a new kidney in without removing any the position isn't hugely important? Perhaps why did the kidney(s) stop functioning would be relevant, but why is which one relevant?