A nephrectomy is the surgical procedure for removing an entire kidney or a portion of one, commonly performed for various medical reasons. The body is remarkably resilient; a single healthy kidney is generally capable of performing all necessary functions to sustain a healthy life. The remaining kidney adapts to process waste, regulate blood pressure, and maintain the body’s fluid and electrolyte balance effectively. Most individuals who undergo a nephrectomy, particularly healthy donors, can anticipate living a long, full life.
Medical Necessity and Donor Removal
The decision to remove a kidney is typically driven by a serious health condition or the altruistic choice of organ donation. The most frequent medical reason is kidney cancer, such as renal cell carcinoma, requiring the removal of the entire kidney (radical nephrectomy) or just the diseased part (partial nephrectomy). Other necessities include severe infections unresponsive to treatment, end-stage kidney disease causing systemic issues, or irreparable trauma. Removal eliminates the source of disease or malfunction.
The second major category is elective nephrectomy for living kidney donation. This procedure is performed on healthy individuals who choose to donate one kidney for transplantation. Potential donors undergo rigorous screening to ensure their remaining kidney is fully functional and they are in excellent health. This strict evaluation ensures donors have excellent long-term health outcomes, demonstrating the body’s ability to thrive with a single kidney.
Surgical Techniques for Nephrectomy
Nephrectomy can be performed using distinct surgical approaches that vary in incision size and recovery time. The traditional method is open nephrectomy, which involves a large incision, often 8 to 12 inches, made in the side or abdomen for direct access. This approach is typically necessary for very large tumors or complex cases requiring extensive dissection.
Modern techniques favor minimally invasive procedures, associated with reduced pain, less blood loss, and shorter hospital stays. Laparoscopic nephrectomy uses several small “keyhole” incisions to insert a camera (laparoscope) and specialized instruments. The surgeon performs the operation while viewing a magnified image on a video screen.
Robotic-assisted surgery refines the laparoscopic technique, allowing the surgeon to control instruments from a console. The robotic system offers enhanced 3D vision, greater dexterity, and a wider range of instrument motion, benefiting complex dissections. Whether laparoscopic or robotic, these minimally invasive methods are the standard of care for many nephrectomy cases, including the removal of a healthy donor kidney.
Maintaining Health with a Single Kidney
The remaining kidney begins to compensate almost immediately after removal, a process known as compensatory hypertrophy. The single kidney increases in size and function, with the individual nephrons—the filtering units—working harder to handle the entire workload. This adaptation aims to normalize the overall Glomerular Filtration Rate (GFR), often achieving 75% to 85% of the function of two healthy kidneys long term.
Regular medical monitoring, typically including annual check-ups, is important to ensure the longevity of the single kidney. Healthcare providers routinely check blood pressure, as hypertension can strain the remaining kidney. Monitoring includes blood tests to estimate GFR and urine tests to check for protein (albuminuria), which indicates stress on the filtering units.
Specific lifestyle adjustments minimize long-term strain on the solitary kidney. A balanced diet with moderate protein intake (0.8 to 1.0 grams per kilogram of body weight per day) is suggested, as excessive protein increases the filtering workload. Limiting sodium intake to under 2.3 grams per day helps control blood pressure and reduce fluid retention.
Adequate hydration is encouraged. Individuals should be mindful of over-the-counter medications damaging to kidney function, such as nonsteroidal anti-inflammatory drugs (NSAIDs). While regular exercise is beneficial, avoiding high-impact, contact sports is often advised to prevent injury to the sole remaining organ. Consistent follow-up with a specialist is the best strategy for a healthy life with one kidney.