Expert: John Pilcher, MD - 11/8/2009

Question
Hello, thank you for considering my question. Approximately 2 years ago I had renal cancer.  At this time my (L) kidney was totally removed. All test show I am now clear of cancer (knock on wood).  I am 5'8" and 255 pounds and age = 43. I have diabetes type 2, increased cholesterol and blood pressure. Knowing that I have only one kidney left would I be a candidate for lap band or gastric bypass surgery? My doctor of internal medicine feels that I would not. Your advise would be very much appreciated. Thank you.  

Answer
Terry,
Once your doctors can be reasonably certain that you are free of kidney cancer and that you have a low risk of recurrence, I would say that the single remaining kidney is a factor in FAVOR of a bariatric surgical procedure.

I suspect that your internal medicine doc is concerned that the single kidney might not handle the stress of surgery as well as two kidneys would.  There might be just a grain of truth in that concern, but I think it also needs to be considered that your single remaining kidney is also much less able to handle the stress/damage caused by the weight and the diseases that you mentioned.  If we were to artificially limit our thought process to your kidney alone, I believe that your chances of preserved kidney function over the next 30+ years is much better WITH a bariatric surgical procedure than without.

I would encourage you to consult with a Center of Excellence surgeon in your area.

Best wishes,
Dr JP