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Why it's done
By Mayo Clinic staffA surgeon performs a nephrectomy either to remove a diseased kidney or to harvest a healthy kidney intended for an organ transplant.
Kidney function
Most people have two kidneys — fist-sized organs located near the back of the upper abdomen. Your kidneys:
- Filter wastes and excess fluid and electrolytes from your blood
- Produce urine
- Maintain proper levels of minerals in your bloodstream
- Produce hormones that help regulate your blood pressure and that influence the number of circulating red blood cells
Cancer treatment
Often, a surgeon performs nephrectomy to remove a cancerous tumor or abnormal tissue growth in a kidney. The most common kidney cancer in adults, renal cell carcinoma, begins in the cells that line the small tubes within your kidneys. Children are more likely to develop a type of kidney cancer called Wilms' tumor, probably caused by the poor development of kidney cells.
The decision about how much kidney tissue to remove depends on:
- Whether a tumor is confined to the kidney
- Whether there is more than one tumor
- How much of the kidney is affected
- Whether the cancer affects nearby tissue
- How well the other kidney functions
The surgeon makes a decision based on the results of imaging tests, which may include:
- Ultrasound, an image of soft tissues produced with the use of sound waves
- Computerized tomography (CT), a specialized X-ray technology that produces images of thin cross-sectional views of soft tissues
- Magnetic resonance imaging (MRI), which uses a magnetic field and radio waves to produce cross-sectional views or 3-D images
Treatment for other conditions
A partial or radical nephrectomy may be needed to remove severely damaged, scarred or nonfunctioning kidney tissue due to traumatic injury or other diseases.
Donor nephrectomy
A healthy person with good kidney function and a low risk of certain disorders, such as high blood pressure or diabetes, is a good candidate for donating a kidney to someone who needs a transplant. A transplant recipient who receives a kidney from a living donor has a better chance of survival than a person who receives a kidney from a deceased donor.
- Kidney cancer. American Urological Association Foundation. http://www.urologyhealth.org/urology/index.cfm?article=24. Accessed April 5, 2012.
- Nephrectomy. National Kidney Foundation. http://www.kidney.org/atoz/content/nephrectomy.cfm. Accessed April 9, 2012.
- Ramos E, et al. Evaluation of the living kidney donor and risk of donor nephrectomy. http://www.uptodate.com/index. Accessed April 10, 2012.
- Wilms' tumor. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/pediatrics/pediatric_cancers/wilms_tumor.html. Accessed April 9, 2012.
- Renal cell carcinoma. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/genitourinary_disorders/genitourinary_cancer/renal_cell_carcinoma.html. Accessed April 9, 2012.
- Solitary kidney. National Kidney & Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/solitarykidney/. Accessed April 10, 2012.
- Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-6/0/1445/0.html. Accessed April 11, 2012.
- Patel MN, et al. Robotic partial nephrectomy: A comparison to current techniques. Urologic Oncology. 2010;28:74.
- Castle EP (expert opinion). Mayo Clinic, Scottsdale, Ariz. May 8, 2012.
- Adjusted patient survival, deceased donor kidney transplants (table 5.12c). Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR) annual report. http://www.srtr.org/annual_reports/2010/512c_agecat_ki.htm. Accessed April 11, 2012.
- Adjusted patient survival, living donor kidney transplants (table 5.12d). Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR) annual report. http://www.srtr.org/annual_reports/2010/512d_agecat_ki.htm. Accessed April 11, 2012.
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