Table of ContentsView AllTable of ContentsTypes of SurgeryWhat to ExpectRecoveryLiving With One KidneyComplicationsPathology FindingsOngoing Care
Table of ContentsView All
View All
Table of Contents
Types of Surgery
What to Expect
Recovery
Living With One Kidney
Complications
Pathology Findings
Ongoing Care
Kidney removal, ornephrectomy, is a type of surgery that removes part of akidney(partial nephrectomy) or all of a kidney (simple or radical nephrectomy). There are different approaches to kidney removal surgery, including open and laparoscopic surgery.
This article describes the different types of kidney removal surgery, including how they are performed, possible complications, and what to expect during recovery.
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Types of Kidney Removal Surgery
Nephrectomy can be performed either with traditionalopen surgery(using a scalpel and large incision) or minimally invasivelaparoscopic surgery(using smaller “keyhole” incisions, a narrow lighted scope, and pencil-like tools).
Partial Nephrectomy
With apartial nephrectomy, only part of one kidney is removed. This may be used if a traumatic injury irreversibly damages part of a kidney or abenign (noncancerous) tumorneeds to be removed.
Partial nephrectomy is also considered the gold standard for treating a type of cancer calledrenal cell carcinoma (RCC), in which the tumor is localized and has not spread. It can’t be used for everyone but may be considered forearly-stage RCCwith anegative surgical margin(meaning there are no cancer cells found at the edge of the tissues surrounding the tumor).
What Is Renal Cell Carcinoma?Renal cell carcinoma is the most common type of kidney cancer, accounting for around nine out of every 10 cases.It affects the tubes of the filters of the kidneys known as nephrons.Although RCC usually occurs as a single tumor in one kidney, there can sometimes be two or more tumors in one kidney or tumors in both kidneys.
What Is Renal Cell Carcinoma?
Renal cell carcinoma is the most common type of kidney cancer, accounting for around nine out of every 10 cases.It affects the tubes of the filters of the kidneys known as nephrons.Although RCC usually occurs as a single tumor in one kidney, there can sometimes be two or more tumors in one kidney or tumors in both kidneys.
Renal cell carcinoma is the most common type of kidney cancer, accounting for around nine out of every 10 cases.It affects the tubes of the filters of the kidneys known as nephrons.
Although RCC usually occurs as a single tumor in one kidney, there can sometimes be two or more tumors in one kidney or tumors in both kidneys.
What Are the Signs of Kidney Cancer?
Simple Nephrectomy
Radical Nephrectomy
Radical nephrectomy is the cornerstone treatment for RCC that has notmetastasized(spread to distant organs).On rare occasions, it may be used for metastatic RCC if a person is in good health and it helps them live longer.
Bilateral Nephrectomy
Bilateral (two-sided) nephrectomy is when both kidneys are removed. It is an extreme measure for when both kidneys are damaged to the point that they can no longer meet the body’s needs.
Bilateral nephrectomy may be indicated when a person has:
Bilateral nephrectomy is considered a last resort when all other treatments fail. A person undergoing this procedure requires either akidney transplantor treatments like continuoushemodialysisto stay alive.
Kidney Removal Procedure: How They Are Performed
Nephrectomy is a major surgery that can take three or more hours to complete. The approach can vary based on whether the surgery is open or laparoscopic.
Preoperative ProceduresBefore having a nephrectomy, you will need to undergo a battery of tests to evaluate the condition of your kidneys and your risk of surgical complications. These may include:Urinalysis: A lab evaluation of the composition of your urineRenal function tests: Blood and urine tests that check how well your kidneys are workingElectrolyte panel: A blood test that assesses kidney status based onelectrolytelevelsProthrombin time: A blood test that can determine how well your blood clotsUltrasound: A non-invasive imaging study that visualizes organs with sound wavesKidney biopsy: Procedures that obtain tissue samples to evaluate in the lab
Preoperative Procedures
Before having a nephrectomy, you will need to undergo a battery of tests to evaluate the condition of your kidneys and your risk of surgical complications. These may include:Urinalysis: A lab evaluation of the composition of your urineRenal function tests: Blood and urine tests that check how well your kidneys are workingElectrolyte panel: A blood test that assesses kidney status based onelectrolytelevelsProthrombin time: A blood test that can determine how well your blood clotsUltrasound: A non-invasive imaging study that visualizes organs with sound wavesKidney biopsy: Procedures that obtain tissue samples to evaluate in the lab
Before having a nephrectomy, you will need to undergo a battery of tests to evaluate the condition of your kidneys and your risk of surgical complications. These may include:
After you have been cleared for surgery, the actual procedure may take different forms:
Open Simple Nephrectomy
Open simple nephrectomy is performed as follows:
Open Radical Nephrectomy
Open radical nephrectomy is performed as follows:
Laparoscopic Nephrectomy
Laparoscopic nephrectomy is performed as follows:
Laparoscopic nephrectomy may take longer than an open kidney removal, but people tend to heal from it faster and with less pain.
Kidney Removal Recovery: What to Expect
As with all major surgeries, recovery from a nephrectomy can take time. After a nephrectomy, you will usually stay in the hospital for one to seven days,although recovery can take anywhere from six to 12 weeks.
During Hospitalization
Immediately after surgery, you will be asked to sit on the side of the bed and walk. Doing so promotes blood circulation and helps prevent blood clots. You may also have a tube (catheter) coming from your bladder that will later be removed. There may also be asurgical drainin your incision.
While in the hospital, you may not be permitted to eat for the first day or so but will gradually ease into aliquid dietbefore you can consume more solid food.
Compression socks may be provided to prevent clots in your legs and a potentially serious condition known asdeep vein thrombosis (DVT). Deep breathing exercises may be recommended to reduce the risk ofpneumonia(lung infection).
Pain Management
After a nephrectomy, you can expect pain for anywhere from one to two weeks.The pain can often be managed with over-the-counter drugs likeTylenol (acetaminophen)or 15-minuteice applicationsseveral times a day. Stronger medications, includingopioids, may be prescribed if the pain is severe.
Do not take aspirin, Advil (ibuprofen), Aleve (naproxen), or any othernonsteroidal anti-inflammatory drug (NSAID)unless your surgeon gives you the OK. These drugs can promote bleeding and slow healing.
You will also need to avoid exercises or activities that place stress on the abdominal muscles. This includes heavy lifting (including the lifting of children and groceries) for at least four weeks.
Rest is important during your recovery. Even so, you should try to walk each day, walking a little more than you did the day before.
Incision Care
You may be able to shower when you return home unless you have a surgical drain. If you do, you may need to take a sponge bath until 48 hours after the drain is removed. You should not take an immersion bath for the first two weeks or until your surgeon tells you it’s OK.
If you havesurgical stripson your incision, do not peel them off. Leave them in place for a week or until they fall off.
Always keep the area around the incisions clean and dry to avoid infection. Wash the area daily with warm, soapy water and pat the skin dry. You can cover the wound afterward with a gauze bandage if there is any weeping, but be sure to change it daily. Do not clean the incision with alcohol or hydrogen peroxide, which can delay healing.
If you need to cough or sneeze, hold a pillow tightly over the incision to avoid exerting enough pressure on the wound to make it open, rupture, or bleed.
Weight Changes
Weight gain is not uncommon after nephrectomy. It may occur as a result of postoperativeedema, in which fluids accumulate in tissues due to extremeinflammation. It may also result from intravenous (IV) fluids given during surgery. The fluid overload may be limited to the incision site or involve the entire body.
In situations like this, the edema tends to resolve on its own as you heal, though some people needdiuretics(“water pills”) to help ease the fluid overload.
You may also gain weight if you had a kidney transplant. Studies suggest that two out of three transplant recipients gain weight as their kidneys start to function normally again. When this happens, waste products likeurate, which suppress appetite, no longer build up in the system.
On the other hand, weight loss after partial or radical nephrectomy for RCC is linked to an increased risk of cancer recurrence, often within 18 months.
Living With One Kidney: Life After Removal
If you have one kidney removed, there should be no ill effects as long as the other is working normally. In short, one healthy kidney can more than accommodate your body’s needs.
Even so, there are things you will need to do to keep healthy:
What Happens if Your Kidneys Fail?
Kidney Removal Surgical Complications
As with any major surgery, nephrectomy can lead to complications. Some are general surgical complications like postoperative infection, pneumonia, and reactions to anesthesia. Others may be associated with the nephrectomy procedure.
Possible complications of kidney removal surgery include:
The risks tend to be greater with radical nephrectomy than with partial nephrectomy. Even so, the risk of reoperation is greater with partial nephrectomy.
These factors must be assessed to determine which type of surgery is most appropriate for people with RCC. This is especially true given that there is no evidence that partial nephrectomy is any less effective than radical nephrectomy in extending the lives of people with early-stage RCC.
Most Common Complications of Surgery
Pathology Results From Kidney Removal
If a simple or partial nephrectomy is performed, the kidney or retracted tissues are taken to a lab for evaluation. Themedical pathologistis tasked with performing gross (visual) and histological (microscopic) examinations to determine if there are any pathologic (disease-related) findings.
Chief among these is the detection of cancer. If no cancer is found, it is considered a benign pathologic finding.
If a person is known to have cancer, the evaluation of the kidney, adrenal gland, and lymph nodes can inform the cancer stage and grade as well as the appropriate course of treatment.
By definition:
These findings are issued on apathology report, which your surgeon can share and explain to you.
How Kidney Cancer Is Diagnosed
Ongoing Care and Management
If you have a kidney removed, you may experience increased high blood pressure (hypertension). This is because the flow of blood between the kidneys and heart influences your blood pressure, and the loss of one kidney intensifies the pressure between the two. This places stress on the remaining kidney, leading to a possible loss of kidney function over time.
Hypertension After NephrectomyStudies suggest that one in four people who undergo nephrectomy will experience new-onset hypertension irrespective of the type of surgery they had.
Hypertension After Nephrectomy
Studies suggest that one in four people who undergo nephrectomy will experience new-onset hypertension irrespective of the type of surgery they had.
To reduce the burden on your kidney, your healthcare provider may recommend the following interventions if you experience new-onset hypertension after kidney removal:
Despite these concerns, most people only experience a mild loss of kidney function after a nephrectomy. In the absence of cancer, a person with one kidney can go on to live a normal, healthy life.
Life Expectancy After Kidney Removal
Summary
Nephrectomy is the surgical removal of part or all of a kidney. It may be performed as an open or laparoscopic surgery to treat conditions ranging from kidney trauma and renal vein hypertension tokidney cancerand end-stage renal disease.
Nephrectomy is a major surgery performed under general anesthesia. Recovery can take anywhere from six to 12 weeks. If both kidneys are removed, a kidney transplant or hemodialysis is necessary to keep the person alive.
How Kidney Cancer Is Treated
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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