Long live the kidney despite every threats: a case report

TL;DR

An elderly patient maintained kidney function for 10 years despite multiple comorbidities and surgeries.

Contribution

This case report highlights the potential for kidneys to remain functional despite significant health challenges.

Findings

A 75-year-old patient retained kidney function for 10 years after a nephrectomy and with multiple comorbidities.

Early diagnosis and treatment of comorbidities may help preserve kidney function in elderly patients.

The patient's eGFR decreased over time but remained functional without dialysis.

Abstract

Kidneys are functionally affected by the diseases of other organs. Here, we present an elderly predialysis patient with a functioning kidney for 10 years of nephrological follow-up despite many comorbidities. A 75-year-old male patient with a medical history of hypertension for 15 years and 60 pack years of cigarette smoking, was diagnosed as muscle invasive bladder cancer (MIBC) and synchronous centrally located clear cell renal cell carcinoma (ccRCC) in the left kidney. At admission, the patient had an Estimated Glomerular Filtration Rate (eGFR) (CKD-EPI-cre) of 54mL/min/1.73m2, after left nephrectomy eGFR of the patient decreased to 35 mL/min/1.73m2. After ten years of follow-up, the patient's right kidney had been functional with a eGFR of 24 mL/min/1.73m2 despite radical cystectomy with urinary diversion, radical nephrectomy, heavy smoking, [cardiorenal syndrome, chronic obstructive pulmonary disease, and hypertension. It is well known that comorbidities such as hypertension, smoking, cancers, infections, pulmonary and heart diseases contribute to irreversible kidney damage and are additive to decreasing kidney function. Appropriate and early diagnosis and treatment of these comorbidities permit healthy aging of the kidneys without the need for dialysis.

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