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Nephrectomy

(Kidney Removal)

How to Say It: Neh-FREK-toh-mee

Definition

A nephrectomy removes all or part of a kidney.

Reasons for Procedure

This surgery may be done for many reasons, such as:

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

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Damage to other organs or structures
  • Leakage of urine from the remaining kidney, if only part of the kidney is removed

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Cleaning out the bowels

Anesthesia

The doctor may give general anesthesia. You will be asleep.

Description of Procedure

This surgery may be done one of two ways:

Open Surgery

An incision will be made in the abdomen. A rib may need to be removed to access the kidney. The tube from the kidney to the bladder is called the ureter. If the whole kidney is removed, the ureter and blood vessels will be cut first. If only part of the kidney is removed, the ureter and blood vessels will be kept. The incisions will be closed with stitches. A bandage will be placed over the site.

Laparoscopic Surgery

Small incisions are made in the abdomen. A tube will be passed through one of the incisions. It will push gas into the belly. This will make it easier for the doctor to view the area. A thin, lighted tube will be passed through an incision. It has a camera to help the doctor to see inside. Tools will be passed through the incisions. The same steps will be used to detach the kidney.The incisions will be closed with stitches. A bandage will be placed over the site.

If both kidneys are removed hemodialysis or kidney transplantation will be needed.

How Long Will It Take?

Between 2 to 4 hours

Will It Hurt?

Pain and swelling are common in the first week. Medicine and home care help.

Average Hospital Stay

The usual length of stay is 2 to7 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

After the procedure, the staff may:

  • Give pain medicine
  • Give IV nutrition
  • Check blood pressure, electrolytes, and fluids

Preventing Infection

During your stay, the hospital staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your chance of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incision

At Home

Recovery may take about 6 weeks. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay return to work.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever or chills
  • Redness, swelling, excess bleeding, or discharge from the incision
  • Lasting nausea or vomiting
  • Pain that you cannot control with medicine
  • Problems urinating

If you think you have an emergency, call for medical help right away.

RESOURCES:

National Cancer Institute
http://cancer.gov

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

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

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

REFERENCES:

Antonelli A, Veccia A. et al. Outcomes of partial and radical nephrectomy in octogenarians - a multicenter international study (resurge). Urology. 2019 Jul;129:139-145.

Kidney cancer. Urology Care Foundation website. Available at: https://www.urologyhealth.org/urology-a-z/k/kidney-cancer.. Accessed January 14, 2021.

Renal cell carcinoma. EBSCO DynaMed wesbite. Available at: https://www.dynamed.com/condition/renal-cell-carcinoma. Accessed Januray 14, 2021.

Last reviewed February 2020 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 1/14/2021