Kidney Info

What are the kidneys?

The kidneys are two bean-shaped, reddish-brown organs. Each are about the size of a fist. They are located on either side of the spine, under the lower ribcage.

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What do the kidneys do?

The kidneys' main job is to clean the blood. They also play an important role in:

Regulating water
Balancing chemicals in the body
Regulating the building of bone
Regulating blood pressure
Controlling the production of red blood cells

What happens if the kidneys don't work?

Kidney disease has two main causes: diabetes and high blood pressure. Kidney failure is when the kidneys can no longer filter the blood properly, so toxic waste products and fluid build up in the blood. If this happens, there are two treatment options:

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Option 1: Transplantation

Although not a cure, a transplant offers the best possible improvement to health for people living with kidney failure. There are two different types of transplants:

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(1) Living kidney donor transplant

This is when a living person gives one of their kidneys to someone who needs it. The donor can be related or unrelated to the recipient. Living kidney donor transplants offer many advantages over deceased kidney donors. The waiting time is decreased, and the recipient may not need to go on dialysis. This option is also usually more successful, with transplants lasting longer (15-20 years) and rejection less likely.

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(2) Deceased kidney donor transplant

This is when a kidney becomes available for transplantation after someone has died. The kidney is removed with the consent of family or from previous donor consent. It is then stored on ice or connected to a machine that provides it with oxygen and nutrients until it is transplanted. Deceased kidney donor transplants last 10-15 years.

What happens if a living kidney donor is not a match?

An incompatible pair may occur when the donor and recipient are not a match. The Canadian Blood Services Kidney Paired Donation Program allows incompatible pairs to be matched with other incompatible pairs so that both recipients get a kidney. Here is an example of this:

Will wants to give a kidney to his sister Cecily,but they're not a good match. Zoya wants to give a kidney to her husband Nikolai, but they're also not a good match. However, Will is a match for Nikolai, and Zoya is a good match for Cecily. The two pairs swap kidneys so that everyone that needs a transplant gets one.

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The Ottawa Hospital participates in the Kidney Paired Donation Program managed by Canadian Blood Services. During the COVID-19 pandemic, Air Canada has been recruited to ship donated kidneys to patients in need across Canada. This way, a living donor in Toronto matched with a patient in Vancouver does need to travel to donate their kidney. The success of the program has motivated Canadian Blood Services to consider the possibility of kidney shipment as a standard post-COVID-19.

Option 2: Dialysis

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Dialysis is a method of artificially cleaning the blood. There are two types:

1. Hemodialysis: Blood is passed through a machine outside the body that cleans it.

2. Peritoneal dialysis: Blood is cleaned inside the body in the peritoneal cavity, an area that surrounds the abdominal organs.

Dialysis can be hard because it must be done regularly and requires dietary restrictions.

Kidney Donation Myths

Myth #1: Living with one kidney causes serious health issues.

Fact: There is good evidence that living with one kidney has little impact on your overall health, including lifespan. One healthy kidney provides more than enough filtering function to clean your blood. In some donors, small amounts of protein may be in the urine and if protein levels reach a certain level, a doctor will prescribe medication to control the amount and prevent any kidney damage. There is a slightly increased risk to develop high blood pressure and this can happen over several years. The overall risk of developing kidney failure is low in the long term. Approximately, 3 in 1000 kidney donors develop kidney failure in the first 15 years after donation.

Myth #2: A donor needs to be in perfect health.

Fact: Although a donor does not need to be in perfect health, there are some medical conditions that may limit someone's ability to donate. These include diabetes, kidney disease, most types of cancers, serious heart disease and obesity.

Myth #3: A donor needs to be a family member.

Fact: A donor does not need to be biologically related to the recipient. As long as they are in good health, willing to donate, have a blood type that is compatible with the recipient's, and are over the age of 18, they can donate.

Myth #4: A donor and recipient must be in the same blood group.

Fact: A donor and a recipient do not need to be in the same blood group, but they should have compatible blood types. For example, a donor with O blood can donate to any blood type. A donor with B blood can donate to B or AB blood type recipients. If the donor and recipient are not found to be compatible, a donor can still donate their kidney through the Kidney Paired Donation Program. Note also that the criteria to be a living organ donor are not the same as to donate blood. Sometimes, you cannot donate blood but you can donate a kidney.

Myth #5: Not all major religions support organ donation.

Fact: Most religions in Canada support organ donation and encourage it as an act of generosity & compassion.

Myth #6: A donor will have debilitating pain all the time.

Fact: A donor may have some pain after surgery from incisions, gas and bloating. This pain can be controlled with pain medication and will decrease over time. By week 2-4, there should be no pain and the donor should be able to resume most daily activities.

Myth #7: A donor can no longer do sports.

Fact: A donor should be able to return to regular activities, including sports and exercise, 4-6 weeks after surgery. Until then, a donor should avoid lifting anything heavier than 10 pounds to allow their muscles to heal properly.

Myth #8: A donor will have to follow a new diet plan.

Fact: A donor should eat a healthy, well-balanced diet. There are no dietary restrictions after donation.

Myth #9: A donor should not get pregnant after donation.

Fact: It is recommended that a donor wait 6 months after surgery before becoming pregnant. Most living kidney donors go on to have uncomplicated pregnancies without harm to the baby. There is a slightly increased risk of developing high blood pressure during pregnancy after donation.

Myth #10: Donating a kidney reduces the donor's life expectancy.

Fact: Donating a kidney does not decrease a person's life expectancy. Interestingly, because living kidney donors are very healthy, they were found in one study to outlive the average person.

Myth #11: Donors must take medication for the rest of their life.

Fact: Kidney donors may take pain medications after surgery or antibiotics if they develop a wound infection. This would be for a short period. However, they should not need any long-term medications related to kidney donation. Kidney donors do not need to take medication. If new health issues come up during their lifetime, medications may be required. This is the same as anyone else who did not donate a kidney.

Myth #12: A donor will be in the hospital for a long time.

Fact: The hospital stay for a living kidney donor is 2-4 days long. At the time of discharge, most donors will be able to bathe, dress and fully care for themselves.

Myth #13: If I decide to donate, I can't change my mind.

Fact: If you decide not to donate, we will maintain your privacy at all times. The donor team will report that you cannot donate at this time for health reasons. It will be up to you if you wish to give more information. You can change your mind at any time, even the day of surgery.

Myth #14: The transplant will be scheduled immediately.

Fact: The timing of the surgery will depend on the needs of the recipient. If the recipient is on dialysis, the surgery can take place soon after the evaluations are complete. The average evaluation period is 2-4 months.

If the recipient is followed by the Multicare Kidney Clinic, it will depend on how much kidney function they have. Sometimes their function deteriorates quickly, while other times it may take months or years for them to be ready for the transplant. We will try to give you as much notice as we can about the transplant date.

Myth #15: The kidney removed is chosen randomly.

Fact: For both types of nephrectomy, the left kidney is usually chosen. It tends to have longer blood vessels and is easier to access. In some cases the surgical team may decide to remove the right kidney for transplant, if it is in the best interest of the donor.

Myth #16: Transplant surgery carries many common risks.

Fact: Shortly after the donation, donors face a few risks, which are relatively uncommon. These are summarized below:

Allergic reaction to anesthetic, <2% risk
Lung collapse (pneumothorax), <2% risk
- The lung often heals on its own.
Blood clots, <2% risk
- This risk can be reduced using compression stockings, blood thinners and early mobilization.
Bleeding, <5% risk
- The Ottawa Hospital has a blood conservation program which allows you to bank your blood before surgery in case you need a transfusion.

Myth #17: Only young people can donate.

Fact: There is no age cut-off to donate a kidney, as long as the donor is at least 18 years old. The oldest living kidney donor at The Ottawa Hospital donated at 77 years old.