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  Monday, 02 March 2015
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Hi!  I am an Occupational Therapist who has just begun dating a man who is 42 who was born with PUV and by the time he was 6 months old, one kidney had completely died, and in his early 20's he required a kidney transplant for the remaining one.  I know very little about kidney disease, and less so in the young and someone in their 40's.

I contacted the Kidney Foundation and they directed me to your website....Without sound too morbid, I am hoping to have a family and am interested to know what life might be like for someone with one kidney for quality of life and life expectancy.  Rather than retiring in the winter down in Louisiana, does the future hold us being here while he accesses a dialysis machine q 3 days? What are the chances he will require another transplant, or once you get one transplant, you are good for life?  I know he was on dialysis for 2 years in his 20's but once he got the transplant there has been no need, however, he has volunteered he takes numerous oral medications.  He hates hospitals and unfortunately most doctors, and thus only sees his GP q 3 months and has not stepped foot into Kingston General's Nephrology Unit for a number of years.  His rationale is that the doors open up right onto the cold and Lake Ontario, and he feels pts who are auto immune suppressed should not be subjected to those conditions....he's a red head...I think part if of it is stubbornness!!   From what I've read, it does not appear PUV is hereditary, just the way biology turns us out!  I don't want to bombard him with too many questions as I have only known him for about 4 weeks now, but I want to learn more behind the scenes and then once I get to know him a bit more, can ask him some personal questions too!

Any suggested reading for me would be appreciated!

Thank you kindly, Michelle 

Thanks very much for your question.

Life on dialysis and life with a kidney transplant are a very different matter. One can have a very normal quality of life with a kidney transplant, especially as many years in to it as your boyfriend seems to be be. This is provided that he has relatively good kidney function, a variable that you did not mention and which would be important to forecast. His urologic condition will not recur at this point (and is unlikely hereditary) therefore the kidney he has would be subject to rejection pressures and to other diseases that can develop in the transplant scenario, namely diabetes and something called chronic allograft nephropathy. On the other hand, some kidneys have been known to last decades and the recipient develops tolerance to the graft, with little to know deterioration in function over time - in whom this happens is very hard to predict.

If one has to return to dialysis, which does occur in many transplant patients, they could be considered for another kidney transplant at that point. Living on dialysis is indeed a challenge but there are many forms of dialysis that provide excellent clearance such that patients feel well. But it is a major adjustment.

Finally, while I understand his stubbornness, it would be very important to maintain some follow-up for medication renewals, checks of his kidney function and periodic drug levels where applicable.

Dr. Jordan Weinstein
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