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Nephrectomy

(Kidney Removal)

Pronounced: Neh-FREK-toh-mee

by Diana Kohnle

En Español (Spanish Version)
 

Definition

In a radical nephrectomy, the whole kidney is removed. In a partial nephrectomy, only a piece of the kidney is removed.

 

Reasons for Procedure

Kidney removal may need to be done because of:

  • Birth defects
  • Injuries to the kidney
  • Infection
  • Tumor
  • Kidney donation for a transplant
 

Possible Complications

Complications are rare. But, no procedure is completely free of risk. If you are planning to have a nephrectomy, your doctor will review a list of possible short-term complications, which may include:

  • Infection
  • Bleeding
  • Blood clots
  • Damage to nearby organs
  • Reactions to the anesthesia
  • Leakage of urine from the remaining kidney tissue, if only part of the kidney is removed

Long-term complications from decreased kidney function may include:

  • High blood pressure
  • Chronic kidney disease

Factors that may increase the risk of complications include:

  • Smoking
  • Prior kidney surgery
  • Obesity
  • Alcoholism
  • Poor nutrition
 

What to Expect

Prior to Procedure

Your blood type is checked. This is done in case a transfusion is needed before or after surgery.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

  • Aspirin or other anti-inflammatory drugs
  • Blood thinners

Do not eat or drink after midnight before the procedure. You may need to take medicine to cleanse your bowels.

Anesthesia

General anesthesia will be given. You will be asleep.

Description of Procedure

A tube called a catheter will be inserted. An incision will be made in the abdomen or side of the abdomen. A rib may need to be removed to access the kidney. The tube from the kidney to the bladder is known as the ureter. If the whole kidney is being removed, the ureter and blood vessels will be cut. The kidney or part of the kidney will then be removed. The incision will be closed.

Kidneys, Ureters, and Renal Blood Vessels

The Urinary System

Copyright © Nucleus Medical Media, Inc.

Laparoscopic surgery may also be used for a nephrectomy. The abdominal cavity will be inflated with gas. Several keyhole incisions are made in the area. A laparoscope, a long tool with a camera on the end, will be inserted through one of the holes. This allows the doctor to see inside you. Tools will be inserted through the other holes to perform the surgery. The same steps will be used to detach the kidney. A small incision will be made to remove the kidney.

How Long Will It Take?

Between 2-4 hours

How Much Will It Hurt?

Anesthesia will prevent pain during the surgery. Recovery is usually painful because of the location of the incision. The laparoscopic approach is much less painful. Your doctor will give you medicine to manage the pain.

Average Hospital Stay

The typical hospital stay after a nephrectomy is 2-7 days. The exact length depends on the type of surgery. Your doctor may choose to keep you longer if complications occur.

Post-procedure Care

At the Hospital

IV fluids and pain medicine will be given after surgery. Blood pressure, electrolytes, and fluid balance will all be carefully monitored. A urinary catheter is often needed for a short time following surgery.

You will be encouraged to move around and be cautiously active as symptoms allow.

At Home

Avoid difficult exercise or activities for about six weeks. Be sure to follow your doctor's instructions. Ask your doctor about when it is safe to shower, bathe, or soak in water.

If both kidneys are removed, hemodialysis or kidney transplantation is necessary.

 

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever or chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which last for more than two days after you leave the hospital
  • Pain that you cannot control with the medicines you have been given
  • Cough, shortness of breath, or chest pain
  • Difficulty urinating
  • Sudden weakness

In case of an emergency, call for medical help right away.

RESOURCES::

National Cancer Institute
http://cancernet.nci.nih.gov

National Institute of Diabetes and Digestive and Kidney Diseases
http://www2.niddk.nih.gov

CANADIAN RESOURCES::

Health Canada
http://www.hc-sc.gc.ca

The Kidney Foundation of Canada
http://www.kidney.ca

REFERENCES::

Andersen MH, Mathisen L, Oyen O, et al. Postoperative pain and convalescence in living kidney donors—laparoscopic versus open donor nephrectomy: a randomized study. Am J Transplant . 2006;6(6):1438-1443.

Bartlett ST, Schweitzer EJ. Laparoscopic living donor nephrectomy for kidney transplantation. Dialysis & Transplantation .1999;28(6):318-331.

Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidorn C, McDougall EM. Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol . 2000;164(4):1153-1159.

Fabrizio MD, Ratner LE, Montgomery RA, Kavoussi LR. Laparoscopic live donor nephrectomy. Johns Hopkins website. Available at http://urology.jhu... . Accessed May 23, 2013.

Kidney cancer. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=24 . Updated March 2013. Accessed May 23, 2013.

Park YH, Byun SS, Kang SH, et al. Comparison of hand-assisted laparoscopic radical nephrectomy with open radical nephrectomy for pT1-2 clear cell renal-cell carcinoma: a multi-institutional study. J Endourol . 2009;23(9):1485-1489.

6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.


Last reviewed May 2013 by Adrienne Carmack, MD; Michael Woods, MD
Last Updated: 5/23/2013

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