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Thread: TRT - Single Kidney

  1. #1
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    Default TRT - Single Kidney

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    Greetings… first time poster here.
    I’m curious if anyone has reference material associated with any potential benefits to TRT for individuals with a single kidney.

    I am a 41 year old male, who had my left kidney kidney removed, due to congenital defect, in 2019. The surgery was successful and my remaining kidney function is normal (meaning no specific additional intervention required per my Nephrologist). I recently have become aware of Starting Strength and this forum, and am in the process of gaining information related to my testosterone and associated hormone levels. I am intrigued by the presentation of benefits from TRT for those in my age demographic, and I am wondering if there is any additional evidence of “protective” or otherwise positive benefits for those with a single kidney.

    Any info related to this would be greatly appreciated. Thanks so much!

  2. #2
    Join Date
    Feb 2016
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    Manhattan Beach, CA
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    Quote Originally Posted by gtrfinder View Post
    Greetings… first time poster here.
    I’m curious if anyone has reference material associated with any potential benefits to TRT for individuals with a single kidney.

    I am a 41 year old male, who had my left kidney kidney removed, due to congenital defect, in 2019. The surgery was successful and my remaining kidney function is normal (meaning no specific additional intervention required per my Nephrologist). I recently have become aware of Starting Strength and this forum, and am in the process of gaining information related to my testosterone and associated hormone levels. I am intrigued by the presentation of benefits from TRT for those in my age demographic, and I am wondering if there is any additional evidence of “protective” or otherwise positive benefits for those with a single kidney.

    Any info related to this would be greatly appreciated. Thanks so much!
    I’m covering a lot of stuff here so bear with me.

    I don’t know of any deleterious or beneficial effects of TRT on the kidney. Likewise, weight training per se shouldn’t be deleterious in any way. However, there’s another important issue and that has to do with the high protein diet normally associated with Starting Strength (1 gram/lbs/day which is 2.2 gram/Kg/day).

    You report that your kidney function is normal. This is presumably true because something called your GFR (Glomerular Filtration Rate) was either directly measured by specific tests or estimated by routine labs.

    The GFR is a metric of your kidney function. Normally, high protein intake shouldn’t adversely affect people with a normal GFR. However, your situation may be a little different.

    People with one good kidney generally have normal kidney function. This is because the remaining kidney can compensate and increase its GFR accordingly. Each individual nephron (the functional units of the kidney of which are microscopic) can increase their efficiency by autoregulation. Unfortunately, they have to do this, in part, by increasing their glomerular filtration pressure. This is sort of like causing hypertension inside the kidney to cause it to function more efficiently. With a normal diet, this is NOT felt to be a problem for patients (which is why it’s generally ethical to permit people to donate a kidney).

    The presence of a high protein diet can be problematic though in this setting and in conjunction with already elevated glomerular filtration pressures this CAN cause the development of actual kidney disease. There is actual data to support this.

    One 2019 review article I read about this recommended a protein intake of no more than 1 gram/Kg/day as compared with the 2.2 gram/Kg/day for Starting Strength.

    I don’t know if this recommendation has been formally validated by actual clinical studies that formally tested it. I hate to punt this but I think you’re going to need to discuss this with a knowledgeable nephrologist. Preferably, this should be one who is interested enough in your problem to actually want to work with you in achieving your goals rather than someone who merely wishes to do the conservative thing and give you a blanket, one-size-fits-all recommendation.

    A possibly relevant aside: As a physician (or despite being a physician) I absolutely love Stan Efferding’s book, The Vertical Diet and it seems to be highly endorsed by Mark Rippetoe and other SS coaches. Mark and Ray Gillenwater have both done podcasts with him that you might wish to check out. In the book, he recommends a daily protein intake for “lean, active people who lift weights regularly” of 0.5 to 1.0 gram/lbs/day (1.1 to 2.2 gram/Kg/day). That low end number that he recommends for effective muscle growth is pretty close to the medical recommendation for protecting a solitary kidney.

    Something to think about coming from one of the strongest men in the world.

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