Kidney removal, known as a nephrectomy, is a common surgical procedure. This intervention often represents a life-saving measure or a generous act of organ donation. The kidneys are a pair of bean-shaped organs positioned beneath the rib cage toward the back of the abdomen. Their primary function is filtering waste products and excess fluid from the blood to create urine. While humans are typically born with two kidneys, the body is capable of adapting to function effectively with only one healthy organ.
Why a Kidney Might Be Removed
Kidney removal is performed for two main reasons: medical necessity to treat a disease or injury, or voluntary organ donation.
When a kidney is diseased or damaged beyond repair, its removal is necessary to protect the patient’s overall health. The most frequent medical reason for a nephrectomy is kidney cancer (renal cell carcinoma). Other conditions necessitating removal include severe trauma, irreversible damage from infection or large kidney stones, congenital defects, or non-cancerous diseases causing uncontrolled high blood pressure. In these cases, the goal is to eliminate a source of serious illness and prevent further complications.
The second major reason is living organ donation, where a healthy kidney is removed for transplantation into a patient with end-stage kidney disease. Living-donor transplants generally offer better long-term outcomes for recipients compared to deceased-donor organs. Donors undergo a rigorous screening process to confirm they have two well-functioning kidneys and are in excellent general health. The remaining kidney is expected to compensate fully for the loss.
The Surgical Process of Nephrectomy
The surgical removal of a kidney is called a nephrectomy, and the procedure is categorized based on how much tissue is removed. A simple nephrectomy involves removing only the kidney, typically performed for non-cancerous conditions, severe injury, or organ donation. A radical nephrectomy removes the entire kidney along with surrounding fatty tissue, the adjacent adrenal gland, and sometimes nearby lymph nodes. This is often necessary when treating kidney cancer that may have spread.
The surgery uses one of two main approaches: open surgery or minimally invasive techniques. Open nephrectomy is the traditional method, requiring a single, large incision (up to 12 inches) to access the kidney directly. This approach is now generally reserved for complex cases or very large tumors.
Minimally invasive methods, which include laparoscopic or robotic-assisted surgery, are the standard for most removals, especially for kidney donation. These techniques utilize several small incisions through which the surgeon inserts a camera and specialized instruments. The minimally invasive approach results in less blood loss, a shorter hospital stay, and a quicker overall recovery time compared to open surgery. Patients typically remain hospitalized for one to five days for observation and pain management.
Adjusting to Life with One Kidney
For an individual with one healthy kidney, the remaining organ exhibits a physiological response called compensatory hypertrophy. The single kidney begins to enlarge and increases its filtering capacity. This adaptation allows the solitary kidney to perform nearly the same amount of work as the original pair, generally maintaining a normal quality of life.
Although the compensation is effective, long-term vigilance is necessary to protect the single organ. Regular check-ups are important for monitoring kidney function, which is assessed primarily through blood tests measuring the estimated glomerular filtration rate (eGFR) and creatinine levels. Monitoring blood pressure is also a routine part of follow-up care, as hypertension can place additional strain on the remaining kidney over time.
Lifestyle adjustments help preserve the health of the solitary kidney. Maintaining adequate hydration assists the kidney in flushing out toxins. Dietary recommendations include limiting excessive sodium intake to control blood pressure and adopting a moderate protein diet to avoid placing undue metabolic stress on the organ. Individuals should also avoid nephrotoxic medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, and use caution with high-impact activities that could cause physical injury to the remaining kidney.