Q: I need a kidney disorder that over a period of a year or so will require a transplant. The character is a 55-year-old woman who has only one functioning kidney due to a congenital defect. I’d like her symptoms to be mild at first, then progressively worsen so that she must be on dialysis to survive until a donor can be found. What condition might fit this scenario? What would the symptoms be? How long would her recovery be after the transplant?
A: Virtually any kidney disorder can progress to what we call Chronic Renal Failure (CRF for short). This is where the kidneys are so damaged that they no longer clean the blood, which, along with excreting of water, is their primary function. This can be mild to severe. Many people with CRF rock along for years before function declines to the point that dialysis and/or renal transplant are needed. This is highly variable from person to person and from underlying condition to underlying condition. This means that your character could have CRF for a few months or a decade or so and anywhere in between before either dialysis or transplant entered the picture.
Common underlying causes of CRF are high blood pressure (hypertension or HBP), Diabetes, Glomerulonephritis (comes in many types and as a group are processes that inflame and damage the kidneys), many of the so-called autoimmune diseases (Lupus, Scleraderma, Dermatomyositis, Rheumatoid Arthritis, and others), and many other illnesses. A common congenital problem that would work for you would be Polycystic Kidney Disease where the kidneys are gradually damaged as cysts develop and grow within the kidneys. Your character could easily lose one kidney to this and then have the other one fail as the disease progresses. CRF in this entity can begin at almost any age.
The symptoms of CRF vary depending on the underlying cause. In general, CRF causes fatigue, poor appetite, weight loss, and edema of the feet and hands as fluid accumulates in the body. When CRF becomes severe, added symptoms could be shortness of breath, sleepiness, confusion, disorientation, coma, and death. Dialysis is used until a suitable kidney donor is located.
Recovery from the transplant is similar to any other abdominal surgery. Four or five days to a week or so in the hospital, a few weeks of reduced activity and then by about 6 to 10 weeks she would be back to normal. This all assumes that the transplant was successful, that there was no rejection, and that her kidney function returned to normal or nearly so fairly quickly after surgery.