When the whole kidney must go
Large tumours, tumours involving the renal hilum or collecting system, tumours with venous extension, and kidneys already destroyed by the disease. In these situations attempting to preserve a fragment of kidney compromises cancer clearance without meaningful functional gain.
The operation
The kidney is removed with its surrounding fat and covering fascia, the vessels are divided and secured, and the adrenal gland is preserved unless involved. Most cases are done laparoscopically through keyhole ports, with an open flank or midline approach reserved for very large tumours or tumour thrombus.
- Two to four days in hospital
- Normal routine in two to three weeks after keyhole surgery
- Histopathology gives the stage and grade that determine follow-up
- Kidney function is checked before discharge and at follow-up
Living with one kidney
The remaining kidney enlarges slightly and takes over the work. Creatinine may settle at a marginally higher level and that is expected. Blood pressure control, good sugar control if diabetic, adequate hydration and avoiding routine NSAID painkillers protect it for life.
Radical Nephrectomy — common questions
How long does recovery take?
Two to three weeks after laparoscopic surgery, six weeks after open surgery before heavy activity.
Will I need dialysis after losing a kidney?
Not if the other kidney is healthy. Dialysis becomes a consideration only when the remaining kidney is already significantly impaired.
Is the adrenal gland removed too?
Only when imaging or surgical findings suggest involvement. Otherwise it is left in place.
Do I need treatment after surgery?
Most organ-confined tumours need only surveillance imaging. Higher-risk cases are discussed with medical oncology for adjuvant therapy.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains radical nephrectomy in general terms; your own treatment plan depends on your reports and examination.