The surgical removal of a kidney is medically termed a nephrectomy. This major operation is performed thousands of times each year for various reasons. The primary role of the kidneys is to filter waste products and excess fluid from the blood, manage electrolyte balance, and produce hormones that regulate blood pressure and red blood cell production. Despite being a major surgery, the human body is resilient, and many people live full, healthy lives with only one kidney.
Medical and Donor Scenarios for Removal
A kidney may be removed for medical necessity (therapeutic nephrectomy) or for voluntary donation (living donor nephrectomy). Therapeutic nephrectomy involves removing a diseased or damaged kidney. Common reasons include cancerous tumors, severe trauma, or chronic, uncontrolled infection posing a risk to the body. The procedure is also performed when a non-functional kidney causes complications like pain or high blood pressure, often seen in cases of end-stage renal disease or polycystic kidney disease.
Living donor nephrectomy involves voluntarily removing a healthy kidney for transplantation into a person with kidney failure. Potential donors undergo extensive medical and psychosocial evaluations to ensure they can safely donate. This rigorous screening typically excludes individuals with diabetes, uncontrolled high blood pressure, or active cancer, and generally requires a Body Mass Index (BMI) of 35 or less. The evaluation confirms the donor will maintain stable kidney function and not face an unacceptable risk after the procedure.
The Nephrectomy Process
The surgical process varies based on the reason for removal and the patient’s overall health. Traditional open nephrectomy uses a single, larger incision, often eight to twelve inches long, made on the side or abdomen. This technique is reserved for cases involving very large cancerous masses or complex anatomy requiring direct visualization. Open surgery generally results in a longer hospital stay and recovery period.
Minimally invasive techniques have become the standard approach for most nephrectomies, especially for living donors. These include laparoscopic or robotic-assisted surgery, which involve several small incisions, typically less than an inch long. Surgeons use specialized instruments and a tiny camera, called a laparoscope, to perform the operation. This approach results in less pain, reduced scarring, and a quicker recovery time compared to the open method.
The procedure is performed under general anesthesia. Immediately following surgery, patients are monitored closely in a recovery area before being moved to a hospital room. The typical hospital stay ranges from one night to a week or more, heavily influenced by the type of surgery performed. Patients are encouraged to walk soon after the operation to aid recovery and minimize the risk of complications like blood clots.
Adapting to Single Kidney Function
The body is well-equipped to handle the loss of one kidney, and the remaining organ undergoes a physiological adjustment. This compensation process allows the single kidney to take over the work of both, often achieving near-normal overall function. The remaining kidney increases in size and function, a phenomenon known as compensatory hypertrophy and hyperfiltration. This means the filtering units increase their filtration rate to process a greater volume of blood.
Most individuals with one kidney live healthy, normal lives, but long-term monitoring is important to protect the remaining organ. Long-term care involves lifestyle adjustments and routine medical check-ups. Maintaining proper hydration and managing blood pressure are important. Regular monitoring of kidney function and protein levels in the urine is recommended to catch potential issues early. Individuals are also advised to avoid contact sports or activities that carry a high risk of abdominal trauma.