Kidney Removal

Alternate Names
nephrectomy

Definition of Kidney Removal

Kidney removal, or nephrectomy, is a surgery to remove a diseased or damaged kidney, or a normal kidney for donation to another person.

Who is a candidate for the procedure?

A kidney may be removed if a person:

• has cancer or suspected cancer of the kidney
• has severe kidney trauma, or damage from an injury
• has a kidney that has poor function due to infection
• is donating his or her kidney to another person who needs a kidney transplant

How is the procedure performed?

There are three basic types of kidney removal, including:

• simple nephrectomy, which involves removal of kidney only
• radical nephrectomy, which involves removal of the kidney, the adrenal gland above the kidney, the surrounding fatty tissue, and the lymph nodes next to the kidney. Lymph nodes, sometimes called glands, are part of the immune system. This procedure is usually done when cancer of the kidney is present.
• partial nephrectomy, which involves removing only part of one kidney. This is not usually attempted unless a person has only one kidney.

A kidney removal is usually done using general anesthesia. This means that a person is put to sleep with medication, has no awareness of the procedure, and can feel no pain.

The traditional type of surgery is called open nephrectomy. This usually involves making a relatively large cut into the person's side and dissecting through the muscle layers to reach the kidney. Sometimes, an approach is made through the abdomen to the kidney, which lies behind the posterior abdominal wall.

The ureter, which is the tube that carries urine from the kidney to the bladder, and the large blood vessels leading to and from the kidney are tied off and cut away from the kidney. The kidney is then removed and the incision closed in layers.

A kidney can also be removed using a more modern type of surgery called laparoscopy. In a laparoscopy, the abdomen is filled with carbon dioxide gas, through a needle, to enable the surgeon to see the interior structures more easily. Then, three or more small cuts are made at key points, one on the body surface near the kidney and the others into the abdomen.

A pencil-sized tube with a light and camera attached to the end of it is then inserted through one of the abdominal cuts into the region behind the abdomen. The surgeon uses other thin tools that are inserted through the other small cuts to free the kidney. The kidney is then removed through a slightly larger cut in the lower abdomen.

What happens right after the procedure?

After surgery, the person will be taken to the surgery recovery room. He or she is watched closely for a short time. The blood pressure, pulse, and breathing rate will be checked often. A urinary catheter will be in place when the person wakes up. This is a tube that drains the urine from the bladder. The urine will be pink colored after the surgery due to mild bleeding.

When the person can urinate on his or her own, the catheter is removed. A tube may be left in the skin incision to drain any blood or fluid from the surgery. Pain is common after surgery, and pain medications are given as needed. The person will be taken to a hospital room to recover once the anesthesia has worn off. The person will gradually be allowed to eat, starting with a liquid diet 1 to 3 days after surgery.

What happens later at home?

A person having a kidney removal usually needs a 5 to 7 day hospital stay. The recovery time depends partly on the person's age, the type of surgery done, other health problems, and any complications. A person who has had a laparoscopy often recovers faster than someone who has had an open nephrectomy. Pain medications are often needed for a few days at home. The person is allowed to slowly increase his or her activity level and diet.

What are the potential complications after the procedure?

Surgery can be complicated by bleeding, infection, or reactions to anesthesia. If both kidneys are removed or the remaining kidney does not function well enough, dialysis will be needed. Dialysis is a procedure to filter the blood. It is often needed three times a week for life or until a kidney transplant can be obtained.

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