Notes

Kidney

The kidneys are two bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about 11 centimetres (4.3 in) in length. They receive blood from the paired renal arteries; blood exits into the paired renal veins. Each kidney is attached to a ureter, a tube that carries excreted urine to the bladder.Encyclopedia Entry for Kidney :Kidney biopsy. A kidney biopsy is done in the hospital. The two most common ways to do a kidney biopsy are percutaneous and open. These are described below. Percutaneous biopsy Percutaneous means through the skin. Most kidney biopsies are done this way. The procedure is usually done in the following way: You may receive medicine to make you drowsy. You lie on your stomach. If you have a transplanted kidney, you lie on your back. The doctor marks the spot on the skin where the biopsy needle is inserted. The skin is cleaned. Numbing medicine (anesthetic) is injected under the skin near the kidney area. The doctor makes a tiny cut in the skin. Ultrasound images are used to find the proper location. Sometimes another imaging method, such as CT , is used. The doctor inserts a biopsy needle through the skin to the surface of the kidney. You are asked to take and hold a deep breath as the needle goes into the kidney. If the doctor is not using ultrasound guidance, you may be asked to take several deep breaths. This allows the doctor to know the needle is in place. The needle may be inserted more than once if more than one tissue sample is needed. The needle is removed. Pressure is applied to the biopsy site to stop any bleeding. After the procedure, a bandage is applied to the biopsy site. Open biopsy In some cases, your doctor may recommend a surgical biopsy. This method is used when a larger piece of tissue is needed. You receive medicine (anesthesia) that allows you to sleep and be pain-free. The surgeon makes a small surgical cut (incision). The surgeon locates the part of the kidney from which the biopsy tissue needs to be taken. The tissue is removed. The incision is closed with stitches (sutures). After percutaneous or open biopsy, you will likely stay in the hospital for at least 12 hours. You will receive pain medicines and fluids by mouth or through a vein (IV). Your urine will be checked for heavy bleeding. A small amount of bleeding is normal after a biopsy. Follow instructions about caring for yourself after the biopsy. This may include not lifting anything heavier than 10 pounds (4.5 kilograms) for 2 weeks after the biopsy.Tell your health care provider: About medicines you are taking, including vitamins and supplements, herbal remedies, and over-the-counter medicines If you have any allergies If you have bleeding problems or if you take blood-thinning medicines such as warfarin (Coumadin), clopidogrel (Plavix), dipyridamole (Persantine), fondaparinux (Arixtra), apixaban (Eliquis), dabigatran (Pradaxa), or aspirin If you are or think you might be pregnant.Numbing medicine is used, so the pain during the procedure is often slight. The numbing medicine may burn or sting when first injected. After the procedure, the area may feel tender or sore for a few days. You may see bright, red blood in the urine during the first 24 hours after the test. If the bleeding lasts longer, tell your provider.Your doctor may order a kidney biopsy if you have: An unexplained drop in kidney function Blood in the urine that does not go away Protein in the urine found during a urine test A transplanted kidney, which needs to be monitored using a biopsy.A normal result is when the kidney tissue shows normal structure.An abnormal result means there are changes in the kidney tissue. This may be due to: Infection Poor blood flow through the kidney Connective tissue diseases such as systemic lupus erythematosus Other diseases that may be affecting the kidney, such as diabetes Kidney transplant rejection , if you had a transplant.Risks include: Bleeding from the kidney (in rare cases, may require a blood transfusion) Bleeding into the muscle, which might cause soreness Infection (small risk).Renal biopsy; Biopsy - kidney.Kidney anatomy Kidney anatomy Kidney - blood and urine flow Kidney - blood and urine flow Renal biopsy Renal biopsy.Barisoni L, Arend LJ, Thomas DB. Introduction to renal biopsy.Encyclopedia Entry for Kidney :Kidney disease - resources. Resources - kidney disease.Kidney anatomy Kidney anatomy.Encyclopedia Entry for Kidney :Kidney function tests. Kidney anatomy Kidney anatomy Kidney - blood and urine flow Kidney - blood and urine flow Kidney function tests Kidney function tests.Oh MS, Briefel G. Evaluation of renal function, water, electrolytes and acid-base balance.Encyclopedia Entry for Kidney :Kidney removal - discharge. You may have an 8- to 12-inch (20- to 30-centimeters) surgical cut over your belly or along your side. If you had laparoscopic surgery, you may have three or four small cuts.Recovering from kidney removal most often takes around 3 to 6 weeks. You may have some of these symptoms: Pain in your belly or on the side where you had the kidney removed. The pain should get better over several days to a week. Bruising around your wounds. This will go away on its own. Redness around your wounds. This is normal. Pain in your shoulder if you had laparoscopy. The gas used in your belly can irritate some of your abdomen muscles and radiates pain to your shoulder.Plan to have someone drive you home from the hospital. DO NOT drive yourself home. You may also need help with everyday activities for the first 1 to 2 weeks. Set up your home so it is easier to use. You should be able to do most of your regular activities within 4 to 6 weeks. Before then: DO NOT lift anything heavier than 10 pounds (4.5 kilograms) until you see your doctor. Avoid all strenuous activity, including heavy exercises, weightlifting, and other activities that make you breathe hard or strain. Taking short walks and using the stairs is OK. Light housework is OK. DO NOT push yourself too hard. Slowly increase the amount of time and the intensity of your exercise. Wait until you follow up with your health care provider to be cleared for exercise. To manage your pain: Your provider will prescribe pain medicines for you to use at home. If you are taking pain pills 3 or 4 times a day, try taking them at the same times each day for 3 to 4 days. They may work better this way. Be aware that the pain medicine can cause constipation. Try to maintain normal bowel habits. Try getting up and moving around if you are having some pain. This may ease your pain. You may put some ice over the wound. But keep the wound dry. Press a pillow over your incision when you cough or sneeze to ease discomfort and protect your incision. Make sure your home is safe as you are recovering.You will need to keep your incision area clean, dry, and protected. Change your dressings the way your provider taught you to. If stitches, staples, or glue was used to close your skin, you may take a shower. If tape strips were used to close your skin, cover the wounds with plastic wrap before showering for the first week. DO NOT try to wash the tape strips off. Let them fall off on their own. DO NOT soak in a bathtub or hot tub, or go swimming, until your provider tells you it is OK.Eat a normal diet. Drink 4 to 8 glasses of water or liquids a day, unless you are told otherwise. If you have hard stools: Try to walk and be more active. But DO NOT overdo it. If you can, take less of some of the pain medicines your doctor gave you. Some can cause constipation. Try a stool softener. You can get these at any pharmacy without a prescription. Ask your provider what laxatives you can take. Ask your doctor about foods that are high in fiber, or try psyllium (Metamucil).Call your provider if: You have a temperature above 100.5 F (38 C) Your surgical wounds are bleeding, are red or warm to the touch, or have a thick, yellow, green, or milky drainage Your belly swells or hurts You have nausea or vomiting for more than 24 hours You have pain that does not get better when you take your pain medicines It is hard to breathe You have a cough that does not go away You cannot drink or eat You cannot pee (urinate).Nephrectomy - discharge; Simple nephrectomy - discharge; Radical nephrectomy - discharge; Open nephrectomy - discharge; Laparoscopic nephrectomy - discharge; Partial nephrectomy - discharge.Olumi AF, Preston MA, Blute ML. Open surgery of the kidney.Encyclopedia Entry for Kidney :Kidney removal. This surgery is done in the hospital while you are asleep and pain-free (general anesthesia). The procedure can take 3 or more hours. Simple nephrectomy or open kidney removal: You will be lying on your side. Your surgeon will make an incision (cut) up to 12 inches or 30 centimeters (cm) long. This cut will be on your side, just below the ribs or right over the lowest ribs. Muscle, fat, and tissue are cut and moved. Your surgeon may need to remove a rib to do the procedure. The tube that carries urine from the kidney to the bladder (ureter) and blood vessels are cut away from the kidney. The kidney is then removed. Sometimes, just a part of the kidney may be removed (partial nephrectomy). The cut is then closed with stitches or staples. Radical nephrectomy or open kidney removal: Your surgeon will make a cut about 8 to 12 inches (20 to 30 cm) long. This cut will be on the front of your belly, just below your ribs. It may also be done through your side. Muscle, fat, and tissue are cut and moved. The tube that carries urine from the kidney to the bladder (ureter) and blood vessels are cut away from the kidney. The kidney is then removed. Your surgeon will also take out the surrounding fat, and sometimes the adrenal gland and some lymph nodes. The cut is then closed with stitches or staples. Laparoscopic kidney removal: Your surgeon will make 3 or 4 small cuts, most often no more than 1 inch (2.5 cm) each, in your belly and side. The surgeon will use tiny probes and a camera to do the surgery. Towards the end of the procedure, your surgeon will make one of the cuts larger (about 4 inches or 10 cm) to take out the kidney. The surgeon will cut the ureter, place a bag around the kidney, and pull it through the larger cut. This surgery may take longer than an open kidney removal. However, most people recover faster and feel less pain after this type of surgery when compared to the pain and recovery period following open surgery. Sometimes, your surgeon may make a cut in a different place than described above. Some hospitals and medical centers are doing this surgery using robotic tools.Kidney removal may be recommended for: Someone donating a kidney Birth defects Kidney cancer A kidney damaged by infection, kidney stones , or other problems To help control high blood pressure in someone who has problems with the blood supply to their kidney Very bad injury (trauma) to the kidney that cannot be repaired.Risks for any surgery are: Blood clots in the legs that may travel to the lungs Breathing problems Infection, including in the surgical wound, lungs ( pneumonia ), bladder, or kidney Blood loss Heart attack or stroke during surgery Reactions to medicines Risks for this procedure are: Injury to other organs or structures Kidney failure in the remaining kidney After one kidney is removed, your other kidney may not work as well for awhile Hernia of your surgical wound.Always tell your health care provider: If you could be pregnant What drugs you are taking, even drugs, supplements, vitamins, or herbs you bought without a prescription During the days before the surgery: You will have blood samples taken in case you need a blood transfusion. You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Clopidogrel (Plavix), warfarin (Coumadin), and other blood thinners. Ask your provider which drugs you should still take on the day of the surgery. Do not smoke. This will help you to recover quicker. On the day of the surgery: You will most often be asked not to drink or eat anything after midnight the night before the surgery. Take the drugs as you have been told, with a small sip of water. You will be told when to arrive at the hospital.You will stay in the hospital for 2 to 7 days, depending on the type of surgery you have. During a hospital stay, you may: Be asked to sit on the side of the bed and walk on the same day of your surgery Have a tube, or catheter, that comes from your bladder Have a drain that comes out through your surgical cut Not be able to eat the first 1 to 3 days, and then you will begin with liquids Be encouraged to do breathing exercises Wear special stockings, compression boots, or both to prevent blood clots Receive shots under your skin to prevent blood clots Receive pain medicine into your veins or pills Recovering from open surgery may be painful because of where the surgical cut is located. Recovery after a laparoscopic procedure is most often quicker, with less pain.The outcome is most often good when a single kidney is removed. If both kidneys are removed, or the remaining kidney does not work well enough, you will need hemodialysis or a kidney transplant.Nephrectomy; Simple nephrectomy; Radical nephrectomy; Open nephrectomy; Laparoscopic nephrectomy; Partial nephrectomy.Bathroom safety for adults Kidney removal - discharge Preventing falls Surgical wound care - open.Kidneys Kidneys Kidney removal - series Kidney removal (nephrectomy) - series.Babaian KN, Delacroix SE, Wood CG, Jonasch E. Kidney cancer.Encyclopedia Entry for Kidney :Kidney stones - self-care. You visited your provider or the hospital because you have a kidney stone. You will need to take self-care steps. Which steps you take depend on the type of stone you have, but they may include: Drinking extra water and other liquids Eating more of some foods and cutting back on other foods Taking medicines to help prevent stones Taking medicines to help you pass a stone (anti-inflammatory drugs, alpha-blockers) You may be asked to try to catch your kidney stone. You can do this by collecting all of your urine and straining it. Your provider will tell you how to do this.A kidney stone is a solid piece of material that forms in a kidney. A stone can get stuck as it leaves the kidney. It can lodge in one of your two ureters (the tubes that carry urine from your kidneys to your bladder), the bladder, or the urethra (the tube that carries urine from your bladder to outside your body). Kidney stones may be the size of sand or gravel, as large as a pearl, or even larger. A stone can block the flow of your urine and cause great pain. A stone may also break loose and travel through your urinary tract all the way out of your body without causing too much pain. There are four major types of kidney stones. Calcium is the most common type of stone. Calcium can combine with other substances, such as oxalate (the most common substance), to form the stone. A uric acid stone may form when your urine contains too much acid. A struvite stone may form after an infection in your urinary system. Cystine stones are rare. The disease that causes cystine stones runs in families.Drinking a lot of fluid is important for treating and preventing all types of kidney stones. Staying hydrated (having enough fluid in your body) will keep your urine diluted. This makes it harder for stones to form. Water is best. You can also drink ginger ale, lemon-lime sodas, and fruit juices. Drink enough liquids throughout the day to make at least 2 quarts (2 liters) of urine every 24 hours. Drink enough to have light-colored urine. Dark yellow urine is a sign you are not drinking enough. Limit your coffee, tea, and cola to 1 or 2 cups (250 or 500 milliliters) a day. Caffeine may cause you to lose fluid too quickly, which can make you dehydrated.Follow these guidelines if you have calcium kidney stones: Drink plenty of fluids, particularly water. Eat less salt. Chinese and Mexican food, tomato juice, regular canned foods, and processed foods are often high in salt. Look for low-salt or unsalted products. Have only 2 or 3 servings a day of foods with a lot of calcium, such as milk, cheese, yogurt, oysters, and tofu. Eat lemons or oranges, or drink fresh lemonade. Citrate in these foods prevents stones from forming. Limit how much protein you eat. Choose lean meats. Eat a low-fat diet. DO NOT take extra calcium or vitamin D, unless the provider who is treating your kidney stones recommends it. Watch out for antacids that contain extra calcium. Ask your provider which antacids are safe for you to take. Your body still needs the normal amount of calcium you get from your daily diet. Limiting calcium may actually increase the chance that stones will form. Ask your provider before taking vitamin C or fish oil. They may be harmful to you. If your provider says you have calcium oxalate stones, you may also need to limit foods that are high in oxalate. These foods include: Fruits: rhubarb, currants, canned fruit salad, strawberries, and Concord grapes Vegetables: beets, leeks, summer squash, sweet potatoes, spinach, and tomato soup Drinks: tea and instant coffee Other foods: grits, tofu, nuts, and chocolate.Avoid these foods if you have uric acid stones: Alcohol Anchovies Asparagus Baking or brewer's yeast Cauliflower Consomm Gravy Herring Legumes (dried beans and peas) Mushrooms Oils Organ meats (liver, kidney, and sweetbreads) Sardines Spinach Other suggestions for your diet include: DO NOT eat more than 3 ounces (85 grams) of meat at each meal. Avoid fatty foods such as salad dressings, ice cream, and fried foods. Eat enough carbohydrates. Eat more lemons and oranges, and drink lemonade because the citrate in these foods stops stones from forming. Drink plenty of fluids, particularly water. If you are losing weight, lose it slowly. Quick weight loss may cause uric acid stones to form.Call your provider if you have: Very bad pain in your back or side that will not go away Blood in your urine Fever and chills Vomiting Urine that smells bad or looks cloudy A burning feeling when you urinate.Renal calculi and self-care; Nephrolithiasis and self-care; Stones and kidney - self-care; Calcium stones and self-care; Oxalate stones and self-care; Uric acid stones and self-care.Kidney pain Kidney pain.Bushinsky DA. Nephrolithiasis.Encyclopedia Entry for Kidney :Kidney stones - what to ask your doctor. If I had a kidney stone removed, can I get another one? How much water and liquids should I drink every day? How do I know if I'm drinking enough? Is it OK to drink coffee, tea, or soft drinks? What foods can I eat? What foods should I avoid? What types of protein can I eat? Can I have salt and other spices? Are fried foods or fatty foods OK? What vegetables and fruits should I eat? How much milk, eggs, cheese, and other dairy foods can I have? Is it OK to take extra vitamins or minerals? How about herbal remedies? What are the signs that I may have an infection? Could I have a kidney stone and not have any symptoms? Can I take medicines to keep kidney stones from coming back? What surgeries can be done to treat my kidney stones? What tests can be done to find out why I get kidney stones? When should I call the provider?.Nephrolithiasis - what to ask your doctor; Renal calculi - what to ask your doctor; What to ask your doctor about kidney stones.Bushinsky DA. Nephrolithiasis.Encyclopedia Entry for Kidney :Kidney stones and lithotripsy - discharge. You had lithotripsy, a medical procedure that uses high frequency sound (shock) waves to break up stones in your kidney, bladder, or ureter (the tube that carries urine from your kidneys to your bladder). The waves break the stones into tiny pieces.It is normal to have a small amount of blood in your urine for a few days to a few weeks after this procedure. You may have pain and nausea when the stone pieces pass. This can happen soon after treatment and may last for 4 to 8 weeks. You may have some bruising on your back or side where the stone was treated. You may also have some pain over the treatment area.Have someone drive you home from the hospital. Rest when you get home. Most people can go back to their regular daily activities 1 or 2 days after this procedure. Drink a lot of water in the weeks after treatment. This helps pass any pieces of stone that still remain. Your health care provider may give you a medicine called an alpha blocker to make it easier to pass the pieces of stone. Learn how to prevent your kidney stones from coming back. Take the pain medicine your provider has told you to take and drink a lot of water if you have pain. You may need to take antibiotics and anti-inflammatory medicines for a few days. You will probably be asked to strain your urine at home to look for stones. Your provider will tell you how to do this. Any stones you find can be sent to a medical lab to be examined. You will need to see your provider for a follow-up appointment in the weeks after your lithotripsy. You may have a nephrostomy drainage tube or an indwelling stent. You will be taught how to take care of it.Call your provider if you have: Very bad pain in your back or side that will not go away Heavy bleeding or blood clots in your urine (a small to moderate amount of blood is normal) Lightheadedness Fast heartbeat Fever and chills Vomiting Urine that smells bad A burning feeling when you urinate Very little urine production.Extracorporeal shock wave lithotripsy - discharge; Shock wave lithotripsy - discharge; Laser lithotripsy - discharge; Percutaneous lithotripsy - discharge; Endoscopic lithotripsy - discharge; ESWL - discharge; Renal calculi - lithotripsy; Nephrolithiasis - lithotripsy; Renal colic - lithotripsy.Lithotripsy procedure Lithotripsy procedure.Bushinsky DA. Nephrolithiasis.Encyclopedia Entry for Kidney :Kidney stones. Kidney stones Watch this video about: Kidney stones Kidney stones are common. Some types run in families. They often occur in premature infants. There are different types of kidney stones. The cause of the problem depends on the type of stone. Stones can form when urine contains too much of certain substances that form crystals. These crystals can develop into stones over weeks or months. Calcium stones are most common. They are most likely to occur in men between ages 20 to 30. Calcium can combine with other substances to form the stone. Oxalate is the most common of these. Oxalate is present in certain foods such as spinach. It is also found in vitamin C supplements. Diseases of the small intestine increase your risk of these stones. Calcium stones can also form from combining with phosphate or carbonate. Other types of stones include: Cystine stones can form in people who have cystinuria. This disorder runs in families. It affects both men and women. Struvite stones are mostly found in women who have a urinary tract infection. These stones can grow very large and can block the kidney, ureter, or bladder. Uric acid stones are more common in men than in women. They can occur with gout or chemotherapy. Other substances such as certain medicines also can form stones. Nephrolithiasis The biggest risk factor for kidney stones is not drinking enough fluids. Kidney stones are more likely to occur if you make less than 1 liter (32 ounces) of urine a day.You may not have symptoms until the stones move down the tubes (ureters) through which urine empties into your bladder. When this happens, the stones can block the flow of urine out of the kidneys. The main symptom is severe pain that starts and stops suddenly: Pain may be felt in the belly area or side of the back. Pain may move to the groin area ( groin pain ), testicles ( testicle pain ) in men, and labia (vaginal pain) in women. Other symptoms can include: Abnormal urine color Blood in the urine Chills Fever Nausea and vomiting.The health care provider will perform a physical exam. The belly area (abdomen) or back might feel sore. Tests that may be done include: Blood tests to check calcium, phosphorus, uric acid, and electrolyte levels Kidney function tests Urinalysis to see crystals and look for red blood cells in urine Examination of the stone to determine the type Intravenous pyelogram (IVP) Stones or a blockage can be seen on: Abdominal CT scan Abdominal/kidney MRI Abdominal x-rays Intravenous pyelogram ( IVP ) Kidney ultrasound Retrograde pyelogram.Treatment depends on the type of stone and the severity of your symptoms. Kidney stones that are small most often pass through your system on their own. Your urine should be strained so the stone can be saved and tested. Drink at least 6 to 8 glasses of water per day to produce a large amount of urine. This will help the stone pass. Pain can be very bad. Over-the-counter pain medicines (for example, ibuprofen and naproxen), either alone or along with narcotics, can be very effective. Some people with severe pain from kidney stones need to stay in the hospital. You may need to get fluids through an IV into your vein. For some types of stones, your provider may prescribe medicine to prevent stones from forming or help break down and remove the material that is causing the stone. These medicines can include: Allopurinol (for uric acid stones) Antibiotics (for struvite stones) Diuretics (water pills) Phosphate solutions Sodium bicarbonate or sodium citrate Water pills (thiazide diuretics) Tamsulosin to relax the ureter and help the stone pass Surgery is often needed if: The stone is too large to pass on its own The stone is growing The stone is blocking urine flow and causing an infection or kidney damage The pain cannot be controlled Lithotripsy procedure Today, most treatments are much less invasive than in the past. Lithotripsy is used to remove stones slightly smaller than a half an inch (1.25 centimeters) that are located in the kidney or ureter. It uses sound or shock waves to break up stones into tiny fragments. Then, the stone fragments leave the body in the urine. It is also called extracorporeal shock-wave lithotripsy or ESWL. Procedures performed by passing a special instrument through a small surgical cut in your skin on your back and into your kidney or ureters are used for large stones, or when the kidneys or surrounding areas are incorrectly formed. The stone is removed with a tube (endoscope). Ureteroscopy may be used for stones in the lower urinary tract. Rarely, open surgery (nephrolithotomy) may be needed if other methods do not work or are not possible. Talk to your provider about what treatment options may work for you. You will need to take self-care steps. Which steps you take depend on the type of stone you have, but they may include: Drinking extra water and other liquids Eating more of some foods and cutting back on other foods Taking medicines to help prevent stones Taking medicines to help you pass a stone (anti-inflammatory drugs, alpha-blockers).Kidney stones are painful but most of the time can be removed from the body without causing lasting damage. Kidney stones often come back. This occurs more often if the cause is not found and treated. You are at risk for: Urinary tract infection Kidney damage or scarring if treatment is delayed for too long.Complication of kidney stones may include the obstruction of the ureter (acute unilateral obstructive uropathy).Call your provider if you have symptoms of a kidney stone: Severe pain in your back or side that will not go away Blood in your urine Fever and chills Vomiting Urine that smells bad or looks cloudy A burning feeling when you urinate If you have been diagnosed with blockage from a stone, passage must be confirmed either by capture in a strainer during urination or by follow-up x-ray. Being pain free does not confirm that the stone has passed.If you have a history of stones: Drink plenty of fluids (6 to 8 glasses of water per day) to produce enough urine. You may need to take medicine or make changes to your diet for some types of stones. Your provider may want to do blood and urine tests to help determine the proper prevention steps.Renal calculi; Nephrolithiasis; Stones - kidney; Calcium oxalate - stones; Cystine - stones; Struvite - stones; Uric acid - stones; Urinary lithiasis.Hypercalcemia - discharge Kidney stones and lithotripsy - discharge Kidney stones - self-care Kidney stones - what to ask your doctor Percutaneous urinary procedures - discharge.Kidney anatomy Kidney anatomy Kidney - blood and urine flow Kidney - blood and urine flow Nephrolithiasis Nephrolithiasis Intravenous pyelogram (IVP) Intravenous pyelogram (IVP) Lithotripsy procedure Lithotripsy procedure.Bushinsky DA. Nephrolithiasis.Encyclopedia Entry for Kidney :Kidney transplant. Kidney transplants are one of the most common transplant operations in the United States. One donated kidney is needed to replace the work previously done by your kidneys. The donated kidney may be from: Living related donor - related to the person receiving the transplant, such as a parent, sibling, or child Living unrelated donor - such as a friend or spouse Deceased donor - a person who has recently died and who has no known chronic kidney disease The healthy kidney is transported in cool salt water (saline) that preserves the organ for up to 48 hours. This gives the health care providers time to perform tests to ensure that the donor's and recipient's blood and tissue match. PROCEDURE FOR A LIVING KIDNEY DONOR If you are donating a kidney, you will be placed under general anesthesia before surgery. This means you will be asleep and pain-free. Surgeons today can often use small surgical cuts with laparoscopic techniques to remove the kidney. PROCEDURE FOR THE PERSON RECEIVING THE KIDNEY (RECIPIENT) People receiving a kidney transplant are given general anesthesia before surgery. The surgeon makes a cut in the lower belly area. Your surgeon places the new kidney inside your lower belly. The artery and vein of the new kidney are connected to the artery and vein in your pelvis. Your blood flows through the new kidney, which makes urine just like your own kidneys did when they were healthy. The tube that carries urine (ureter) is then attached to your bladder. Your own kidneys are left in place unless they are causing a medical problem. The wound is then closed. Kidney transplant surgery takes about 3 hours. People with diabetes may also have a pancreas transplant done at the same time. This can add another 3 hours to the surgery.You may need a kidney transplant if you have end-stage kidney disease. The most common cause of end-stage kidney disease in the U.S. is diabetes. However, there are many other causes. A kidney transplant may NOT be done if you have: Certain infections, such as TB or bone infections Problems taking medicines several times each day for the rest of your life Heart, lung, or liver disease Other life-threatening diseases Recent history of cancer Infections, such as hepatitis Current behaviors such as smoking, alcohol or drug abuse, or other risky lifestyle habits.Specific risks related to this procedure include: Blood clots (deep venous thrombosis) Heart attack or stroke Wound infections Side effects from medicines used to prevent transplant rejection Loss of transplanted kidney.You will be evaluated by a team at the transplant center. They will want to make sure that you are a good candidate for a kidney transplant. You will have several visits over a period of several weeks or months. You will need to have blood drawn and x-rays taken. Tests done before the procedure include: Tissue and blood typing to help make sure your body will not reject the donated kidney Blood tests or skin tests to check for infections Heart tests such as an EKG, echocardiogram, or cardiac catheterization Tests to look for early cancer You will also want to consider one or more transplant centers to determine which is best for you. Ask the center how many transplants they perform every year and what their survival rates are. Compare these numbers to those of other transplant centers. Ask about support groups they have available and what type of travel and housing arrangements they offer. If the transplant team believes you are a good candidate for a kidney transplant, you will be put on a national waiting list. Your place on a waiting list is based on a number of factors. Key factors include the type of kidney problems you have, how severe your heart disease is, and the likelihood that a transplant will be successful. For adults, the amount of time you spend on a waiting list is not the most important or main factor in how soon you get a kidney. Most people waiting for a kidney transplant are on dialysis. While you are waiting for a kidney: Follow any diet your transplant team recommends. Do not drink alcohol. Do not smoke. Keep your weight in the range that has been recommended. Follow any recommended exercise program. Take all medicines as they have been prescribed for you. Report any changes in your medicines and any new or worsening medical problems to the transplant team. Go to all regular visits with your regular doctor and transplant team. Make sure the transplant team has the correct phone numbers so they can contact you right away if a kidney becomes available. Always make sure that you can be contacted quickly and easily. Have everything ready in advance to go to the hospital.If you have received a donated kidney, you will need to stay in the hospital for about 3 to 7 days. You will need close follow-up by a doctor and regular blood tests for 1 to 2 months. The recovery period is about 6 months. Often, your transplant team will ask you to stay close to the hospital for the first 3 months. You will need to have regular check-ups with blood tests and x-rays for many years.Almost everyone feels that they have a better quality of life after the transplant. Those who receive a kidney from a living related donor do better than those who receive a kidney from a donor who has died. If you donate a kidney, you can most often live safely without complications with your one remaining kidney. People who receive a transplanted kidney may reject the new organ. This means that their immune system sees the new kidney as a foreign substance and tries to destroy it. In order to avoid rejection, almost all kidney transplant recipients must take medicines that suppress their immune response for the rest of their life. This is called immunosuppressive therapy. Although the treatment helps prevent organ rejection, it also puts patients at a higher risk for infection and cancer. If you take this medicine, you need to be screened for cancer. The medicines may also cause high blood pressure and high cholesterol and increase the risk for diabetes. A successful kidney transplant requires close follow-up with your doctor and you must always take your medicine as directed.Renal transplant; Transplant - kidney.Kidney removal - discharge.Kidney anatomy Kidney anatomy Kidney - blood and urine flow Kidney - blood and urine flow Kidneys Kidneys Kidney transplant - series Kidney transplant - series.Becker Y, Witkowski P. Kidney and pancreas transplantation.Encyclopedia Entry for Kidney :Kidney Bean.Latin name: Phaseolus vulgaris.Pinyin name: BAI FAN DOU.Effect(s): To enrich and nourish, resolve heat, disinhibit urine, disperse swelling.Plant part: seed.Encyclopedia Entry for Kidney :Kidneyleaf Goldenray Equivalent plant: Ligularia dentata, Ligularia intermedia , Ligularia sibirica.Latin name: Ligularia fischeri.Pinyin name: HU LU QI.Effect(s): To dispel phlegm, relieve cough, rectify qi and quicken blood, relieve pain.Plant part: root and rhizome.