Why it's done

The most common reason a urologic surgeon performs a nephrectomy is to remove a tumor from the kidney. These tumors are usually cancerous, but they can be noncancerous (benign). Sometimes a nephrectomy is needed because of other kidney diseases.

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 urologic 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.

Kidney tumors in children are rare. But when they occur, 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
  • Whether other diseases affect kidney function
  • Overall kidney function

The urologic surgeon makes a decision based on the results of imaging tests, which may include:

  • 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
  • Ultrasound, an image of soft tissues produced with the use of sound waves
A urologic surgeon discusses the best surgical approach with a kidney tumor patient.

A urologic surgeon uses imaging test results to help determine whether partial or complete nephrectomy is the best surgical approach.

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.

Aug. 15, 2017
References
  1. Nephrectomy. National Kidney Foundation. https://www.kidney.org/atoz/content/nephrectomy. Accessed March 15, 2017.
  2. Leibovich BC (expert opinion). Mayo Clinic, Rochester, Minn. March 8, 2017.
  3. Renal cell carcinoma. Merck Manual Professional Version. http://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/renal-cell-carcinoma. Accessed March 16, 2017.
  4. AskMayoExpert. Wilms tumor. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  5. AskMayoExpert. Partial nephrectomy. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  6. Richie JP. Definitive surgical management of renal cell carcinoma. https://www.uptodate.com/home. Accessed March 16, 2017.
  7. Richie JP, et al. Role of surgery in patients with metastatic renal cell carcinoma. https://www.uptodate.com/home. Accessed March 16, 2017.
  8. Tan HJ, et al. Long-term survival following partial vs. radical nephrectomy among older patients with early-stage kidney cancer. JAMA. 2012;307:1629.
  9. Abaza R, et al. Multi-institutional experience with robotic nephrectomy with inferior vena cava tumor thrombectomy. The Journal of Urology. 2016;195:865.
  10. Stewart-Merrill SB, et al. Oncologic surveillance after surgical resection for renal cell carcinoma: A novel risk-based approach. Journal of Clinical Oncology. 2015;33:4151.
  11. Kim SP, et al. Approach to the small renal mass: To treat or not to treat. Urologic Clinics of North America. 2012;39:171.
  12. Patton MW, et al. Robot-assisted partial nephrectomy for complex renal masses. Journal of Robotic Surgery. 2016;10:27.
  13. Zaid HB, et al. Outcomes following complete surgical metastasectomy for patients with metastatic renal cell carcinoma: A systematic review and meta-analysis. The Journal of Urology. 2017;197:44.
  14. Your kidneys and how they work. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work. Accessed May 10, 2017.
  15. Solitary kidney. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/solitary-kidney. Accessed May 10, 2017.