Kidney issues & diving

[Soggy]

When I was 9 years old (I'm 25 now), I had a UPJ (I think that's what it's called) obstruction removed from my left kidney. Basically, there was a blockage in the ureter. The obstruction, which was congenital, caused my left kidney to become permanently distended. The surgery left a 5x1" scar on my back which is a great conversation piece! My left kidney is 14 cm long vs my right, which is only 10-11 cm long.

Fast forward 15 years...
At age 23 I discovered that I had several large kidney stones in my left kidney, caused by a permanent hydronefrosis(sp...fluid gets caught and takes a while to move through) in that kidney. The stones are all in the lower pole of the kidney and I have had several successful shockwave lithrotripsies to break them up. Most of the fragments have been passed. The stones are caused because of the mechanical problems in my kidney, not any dietary or chemical imbalance. Note also that when a renal scan was done of both kidneys, my left ("bad") kidney was actually doing more of the filtering than my right ("good") kidney...so it is quite functional.

I am curious if my history might increase my diving risk. I have moved since my last checkup and have never discussed this with a doctor. Any input would be appreciated. And pardon my lack of accuracy with spelling the medical procedures above...I'm a computer guy, not a doctor.

 

[DocVikingo]

As this is more of a medical question than one concerning the scientific aspects of decompression, I have taken the liberty of moving it here. Dr. Deco will still see it.

I think BillP should have the first opportunity at responding.

Best regards.

DocVikingo

 

[Soggy]

Whoops...must've clicked on the wrong forum. Thanks!

 

[Soggy]

bump

 

[BillP]

Howdy Aaron:

I can think of a couple of things for you to keep in mind.

First, about surgery. Whenever you read about previous surgery and diving you'll hear about the theoretical increased risk of developing DCS in a scar. Concerning that risk, DAN says:

"From a DCI viewpoint, any condition or injury which compromises blood supply to the musculoskeletal system may impair inert gas uptake and elimination. For this reason, there is always some concern for a theoretical increased risk of decompression sickness at previous surgical sites. Scarring may cause decreased blood flow and less diffusion of inert gases out of the body tissues. There is no data to support this claim, so any risk assertion is in all respects is academic."

In general a diver can return to diving after surgery when the skin wounds have healed adequately, the muscle incisions are strong enough to take the strain of diving, the patient has recovered sufficiently otherwise to allow vigorous activity, the original condition they had the surgery for has improved enough/resolved so it doesn't interfere with diving, there are no significant complications that would interfere with diving, and the patient's doctor says it's OK.

Now, about kidney stones. There is the concern that if a diver should pass a kidney stone, the symptoms could be confused with DCI until the diagnosis is sorted out.

There are also some potential operational considerations concerning passing kidney stones and diving. I could imagine that diving might increase the risk of passing a kidney stone. Divers should drink plenty of fluids to hydrate themselves and diving causes an immersion diuresis with a resultant increase in urine output. (I would not recommend restricting fluids to try to decrease this possiblility.) Passing a stone in a remote dive location such as in a third world country or on a live aboard could be a major inconvenience. Certainly the pain of passing a stone at depth could interfere with diving.

Having said that, I haven't seen where any dive medicine author has said that kidney stones should disqualify someone from diving.

HTH,

Bill

The above information is intended for discussion purposes only and is not meant as specific medical advice for any individual.

 

[Soggy]

Thank you for the reply!

Luckily, I have never had any pain from the stones that were present. They have all broken into small enough fragments that when (in if) they pass, it is not uncomfortable. Since they are in the lower pole of my kidney, it is not easy for them to move much. It sounds as if diving might actually be good for my condition, since the fragments have stayed put for so long...this may help pass them.