Dr. Perez - Children's Urologist

First off, thank goodness for insurance. We've seen more than our fair share of doctors during this pregnancy. The latest was Dr. Luis Perez. He's a children's urologist. He runs his own practice in Charlotte called Children's Urology of the Carolinas. He'll be treating Magnus' Multicystic Dysplastic Kidney (MCDK), learn more about MCDK here. We love Dr. Perez. He was wonderful. Maybe it was just because he was giving us some pretty good news, but more likely it was his intelligence, calm demeanor, and laid back personality that won us over.

We first learned of Magnus' cystic kidney about 10 weeks ago. At the same time that we learned he was a boy, we learned that he was going to need special tests to diagnose the cause of the cystic kidney. We've had two appointments with Dr. Allbert. Dr. Allbert is an obstetrician who specializes in prenatal ultrasound diagnosis and he was the first person to diagnose Magnus' condition. He was able to confirm that the MCDK was only impacting one kidney (right side) and that based on the level of amniotic fluid, he was able to surmise that the left kidney was working well. "What does amniotic fluid have to do with kidneys?" you are probably asking yourself. Well, after the first few weeks, amniotic fluid is made up almost entirely of baby pee (not to be confused with Baby P). Since kidneys create urine, if Magnus' didn't have enough urine, it would have pointed to a bilateral kidney problem. Also, baby's practice breathing by ingesting the amniotic fluid. Insufficient amniotic fluid often leads to BIG problems - like still birth. Needless to say, it was a great relief to see that the problem was only on one kidney and the other kidney was doing its job. Dr. Allbert also reassured us that you only need one kidney to be healthy. In his words, "if you are going to have a problem with an organ, you want it to be an organ that you have two of". Pretty true.

So, after two appointments with Dr. Allbert to confirm his diagnosis of MCDK, we had our first appointment with Dr. Perez. Dr. Perez really put us at ease. He let us know that before we even leave the hospital, he will run a couple of tests on Magnus. One will be an ultrasound of Magnus' kidney. This will show the current size and status of the kidney. The other will confirm that all of the "plumbing" to the good kidney is in working condition. If there are "plumbing" issues - which is common - he will probably just treat them with an antibiotic. As for the MCD kidney, he'll just leave it be and monitor it's size over the next few years. In the past, there was a belief that you should always remove the MCD kidney (perform a nephrectomy). Now, they believe differently. They've found that in a majority of cases, by age five, the child's body has absorbed the MCD kidney, essentially doing the surgeons job without the cutting and the anesthesia. So, they'll just monitor the MCD kidney and make sure that it is shrinking over time. If the body does not absorb it, then we may need to consider the surgery.

Of course, the remaining question was "how is life different for a baby/child/adult with one kidney". The answer, thankfully, was "there are no differences." Dr. Perez encouraged us to allow our child to play contact sports, to run jump and play, and that we didn't need to "baby" him. There are some dietary things that we should watch - reduce sodium intake and have a slightly lower protein diet. Otherwise, he's going to be a normal kid. So, when he starts mouthing off to you and you are getting ready to put him over your knee for a good paddling... don't let him use the "I've only got one kidney" excuse... You just go right ahead and swat him!*

*The Peters Family Blog does not condone corporal punishment