by Diane Curtiss



This document lists items for living donors of kidneys to consider as concerns post donation life with one kidney. These items are guidelines only to aid in discussions with your individual primary care physician. Your situation may be different. Any questions or individual circumstances should be directed to your transplant center or personal physician. This list is not meant to diagnose nor to be used as a substitute for professional medical care.  The items are numbered for easy reference and identification. The numerical sequence is not an indicator of the importance of the particular item.


  1. Wear a medic-alert bracelet or jewelry to alert emergency personnel that you have only one kidney. Be sure to identify which kidney you have – i.e. “One kidney – right”. The bracelet should also identify any allergies or other conditions. Many pharmacies or doctor’s offices have information for placing an order. A source on the internet is American Medical ID at


  1. Do not use Nsaids (Aleve), aspirin, or ibuprofin (Advi). These pain relievers are hard on the kidneys. Use acetaminophen (Tylenol) only. Some transplant centers have said it is okay to use these occasionally, but if you do not have to, it is best not to do so. If you feel you need to use these drugs, discuss this with your personal physician.


  1. Be cautious regarding any over-the-counter medications. Some contain ingredients you may not wish to use such as pseudoephedrine. An example is Pepto-Bismol which contains aspirin. Discuss with your physician and pharmacist which products you may use in the event of a cold, upset stomach, etc. It is best to review acceptable products in advance rather than waiting until you are in the throes of a bad cold.


  1. Be cautious of supplements of ANY kind – even vitamins. Remember that anything you take orally will eventually work its way through your kidneys. The ingredient list of ANY supplement or vitamin should be reviewed with your transplant center and primary care physician before continuing with their use.


  1. Avoid smoking. Among other things, smoking can damage the circulatory system. With one kidney, it is important to keep those arteries and veins in top working condition. Smoking may also lead to high blood pressure, which is damaging to the kidneys.


  1. Use alcohol sparingly. In excess, it can cause dehydration, which is hard on your remaining kidney. Watch the amount of soft drinks you are consuming. Some of the ingredients (particularly in colas) have been linked to kidney stone formation. Kidney stones can cause not only discomfort, but damage to the structure of your remaining kidney. However, do make sure you drink plenty of water. Water will hydrate you and continue to flush impurities from your system.


  1. At EVERY doctor or dentist visit of any kind, be sure you inform the nurse and doctor that you have only one kidney. For any test or procedure ordered, ask how it will affect your remaining kidney. Certain dyes used in MRIs and other tests can be damaging to your kidney. Make sure to ask about any test that uses dye. Following is a recent link regarding potential kidney damage from certain bowel preps:   You need to continue to alert everyone you come in contact with throughout any medical visit or procedure that you have one kidney, and you want to know how the procedures and medications will affect you. You are one of many patients, and sometimes they may forget this valuable information or may not see it listed on your chart.


  1. Alert your pharmacy to note in your records that you have one kidney. In some pharmacies, such information will generate a “tickler” and have any medication dispensed reviewed by the pharmacist before it is dispensed to you. As with the physicians, prescriptions should always be reviewed with the pharmacist regarding any potential for causing problems with your kidney.


  1. Be aware of High Blood Pressure and its potential causes. Uncontrolled High Blood Pressure is one of the leading causes of kidney failure. Your physician should check your pressure annually, but it is also a good idea to check it yourself monthly. It can be monitored with a home blood pressure cuff found in pharmacies or general merchandise stores. Many pharmacies also have a blood pressure cuff machine available for public use. Normal pressure is classified as 120 Systolic (top number) or less and 80 Diastolic (bottom number) or less. However, check with your physician to be sure what is normal for your particular circumstance. Excess salt is one of the main culprits in contributing to high blood pressure. If you have a salt shaker – throw it away! Watch for hidden salt in fast food, restaurant food and processed food. The American Heart Association at has some good information regarding blood pressure, salt, and heart health in general.


  1. Diabetes is also a leading cause of kidney failure. Watch for family history of this disease. Eat well, exercise, and maintain a healthy weight. Consult with your physician regarding monitoring and prevention if you have a family history of this disease.


  1. Exercise of any kind is good! Not only for general health, but as a preventative against high blood pressure and diabetes. Make sure to drink plenty of water during exercise, as you do not want to become dehydrated.


  1. Do not engage in fad diets. Atkins or other high protein style diets should be avoided due to the imbalance they cause in kidney function. Excess protein consumption may cause a problem in persons with compromised kidney function. Discuss with your doctor the amount of protein you should or should not be eating.  Eat a well-balanced, healthy diet with plenty of fresh fruits and vegetables. provides valuable nutrition and dietary information. You may wish to do further research regarding the benefits of organic foods. Normally, the less processing involved, the more nutrition the food item retains. If you have specific dietary needs or restrictions, be sure to review any change in diet with your physician.


  1. Keep up on your immunizations such as tetanus, flu shot, pneumonia shot, etc. Besides being good sense for general health, it can protect you from diseases that would be hard on your body in general.


  1. Have a copy of your donation records sent to your primary care physician. At your next visit, make sure they have read and understand them. At about 4 months post donation, it would be wise to have the following tests to establish baseline kidney function:


·         CBC (Complete Blood Count) – Your kidneys produce a hormone that signals the body to produce red blood cells. This test, among other things, will monitor for anemia.

·         BMP (Basic Metabolic Panel) - This evaluates the current status of the kidneys (including BUN/Blood Urea Nitrogen and Creatinine levels), electrolyte, blood sugar and calcium levels.

·         Urine Analysis with macro, micro and culture – This looks for protein in the urine and potential bacteria in the urine.


            Your primary care physician should repeat these tests each year to compare against your initial baseline numbers. They may order additional tests, as needed, depending on the results. This annual testing will help to identify and treat any problems as early as possible. It is wise for donors to have an annual physical for general health purposes, and these test can be included as part of that annual physical.


  1. Be alert for Urinary Tract Infections (UTI’s). Typical symptoms include frequent urination and pain or burning during urination. Have them treated by your physician as quickly as possible to prevent the infection from potentially traveling to your remaining kidney. You can sometimes prevent UTI’s by drinking plenty of water, and many people recommend drinking cranberry juice as a preventative. It is important for donors, in any case, to drink plenty of water throughout the day to be sure they are well hydrated so their remaining kidney can function properly.


  1. It is wise to avoid heavy contact sports such as football and boxing. The kidney is well protected by the ribs and organs in front of it, but arteries and veins that service the kidney are much more easily damaged.


  1. Be aware of your family medical history and stay alert for possible conditions that could damage your remaining kidney. No one says that you are, for sure, going to be subject to Aunt Myrtle’s diabetes, but it pays to be cautious and do what you can to prevent diseases that run in the family tree. Discuss prevention and signs of potential diseases with your primary care physician.





The following resources can provide some basic information regarding kidney and general health. There are few sources out there specifically directed towards living kidney donors, but sifting through the kidney related websites can provide some information as relates to protecting kidney function.



General Health  American Medical ID

Online retailer of medical identification jewelry  American Heart Association

Information on heart disease and heart healthy nutrition and lifestyles  American Diabetes Association

Information on diabetes prevention. Also provides information on nutrition and exercise that can apply to anyone. US Department of Agriculture

Provides advice on nutrition and healthy eating. Includes tools for meal planning, and individual tracking of exercise and food.  Organic Consumers Association

A good starting point if you wish to do additional research on organic foods.

Provides articles, information and resources.



Kidney Related  National Kidney Foundation

Provides information on kidney health. Some tools provided such as a GFR on line calculator.  US Department of Health & Human Services

National Kidney Disease Education Program. Identifies a good number of resources and topics such as “What do my kidneys do?”; “ How to Talk to your Doctor”; “ How to protect your kidneys”. American Association of Kidney Patients

Provides general information on kidney health  Part of United Network for Organ Sharing (UNOS) website

Some information on living donation, but mainly involving the evaluation and surgery.  Part of “Life Options” website

This website has several educational modules that are in an online educational format and take about 20 minutes each to complete. While the majority are geared towards people with ESRD and dialysis issues, there are a couple “Kidneys – How they work” and “Understand Kidney Lab Tests” that living donors may find useful.