Question 1

1) What is nephrectomy?

Accepted Answer

Nephrectomy is a surgery in which part or whole of a kidney or both kidneys is removed. It can either be done as a laparoscopic surgery or an open one. When only the diseased or injured portion of the kidney is removed, it is known as partial nephrectomy. Removal of the whole kidney along with its ureter, the adrenal gland and the fatty tissue around the kidney is known as radical nephrectomy. Nephrectomy of both kidneys is known as bilateral nephrectomy. When a healthy kidney is removed from the person for donation purpose, it is known as donor nephrectomy.

Question 2

2) What are the indications for nephrectomy?

Accepted Answer

Indications for a nephrectomy include

A kidney tumour or cancer
Acute trauma to the kidney
Chronic infection in the kidney
Renal Calculi (Kidney stones)
Polycystic Kidney Disease (Clusters of cysts form in the kidneys enlarging them and reducing their functioning over time. It is an inherited disorder.)
Hydronephrosis (Swelling of the kidney due to blockage in the ureter)
CKD (Chronic Kidney Disease which causes the kidney to lose its function over time)
ESRD (End Stage Renal Disease which is the last stage of CKD and involves complete failure of the kidney)
Any such condition in which the doctor decides that kidney removal is the only viable option to tackle the condition

Apart from this, nephrectomy is undertaken for people who are donating their healthy kidneys.

Question 3

3) How long does it take to recover from a radical nephrectomy?

Accepted Answer

The surgery itself lasts for 2-3 hours. You will be required to stay in the hospital for three days in case of laparoscopic surgery and up to 5 days in case of open surgery.

Recovery time is variable after discharge, but on average, patients take three weeks to recover from laparoscopic surgery and around six weeks from open surgery.

Question 4

4) Can a kidney tumor be removed?

Accepted Answer

Yes, kidney tumor can be removed through nephrectomy. If the patient has some conditions due to which he/she cannot undergo surgery, then other means are used to tackle a tumor.

Question 5

5) Is Kidney cancer aggressive?

Accepted Answer

If the cancer is discovered at an early stage, chances of survival are very high. However, the more advanced cancer becomes, the lower the survival chances. If the doctor finds sarcomatoid features (these are an irregular, disorganized feature on the normal cancer cells as seen under a microscope) in the cancer cells, the cancer is said to be very aggressive

Question 6

6) What are the complications of nephrectomy?

Accepted Answer

Complication of nephrectomy include –

Infection
Allergic reaction to anaesthesia and medications used during the surgery
Post-operative pneumonia
Haemorrhage which requires blood to be transfused
Kidney failure in patients where the remaining kidney has lowered function or is diseased
Injury to the neighbouring organs

Rarely has nephrectomy led to fatal consequences. The mortality rate of nephrectomy is around 2%.

Question 7

7) What are the side effects of living with one kidney?

Accepted Answer

There are absolutely no side-effects of living with one kidney. A person with kidney can live a healthy and long life. The worst that can happen is high blood pressure later in life and a very mild loss of function of the working kidney.

Question 8

8) What can you eat after kidney removal?

Accepted Answer

A normal diet is recommended after a kidney removal. You will be restricted to a liquid diet for 1-2 days after the surgery depending upon the doctor after which you can resume a normal diet. You should be careful about prescription and over the counter medications. Consult your doctor before taking any of these medications. Engage in a healthy diet and indulge physical activity in your daily schedule.

Recent studies have found that high protein intake and high sodium intake can be linked to CKD (Chronic Kidney Disease) and ESRD (End Stage Renal Disease). CKD is low functioning of the kidney which eventually leads to ESRD which is complete kidney failure. Thus, doctors might encourage you not to take a lot of proteins, especially not protein shakes etc. and to keep your sodium intake to a minimum.

Question 9

9) What is the first sign of kidney cancer?

Accepted Answer

Signs of kidney cancer include-

Blood in the urine
Lower back pain but only on one side without any injury sustained
A lump on the side or lower back
Loss of weight (which is not worked towards)
Perpetual fatigue
Fever that does not go away
Loss of appetite
Low RBC count (Anaemia)

Please remember that these symptoms might not be caused by kidney cancer but people with kidney cancer experience these conditions. You need to go to your doctor and get all the relevant tests done to be sure of what the conditions are.

Question 10

10) Is alcohol consumption allowed after kidney removal?

Accepted Answer

Alcohol consumption has been found to cause problems with a healthy, fully functioning kidney. Although a few drinks here and there do not cause any problems, you are surviving on one kidney and you should not risk getting any kidney related problems. Thus, abstaining from alcohol is recommended, but one or two drinks at some party can be indulged.

Question 11

11) Do people come from abroad for nephrectomy in India?

Accepted Answer

People who are from countries which do not have adequate medical facilities do come to India for nephrectomy. These mainly include developing nations and underdeveloped nations. Since the cost of a nephrectomy is very less compared to other parts of the world, a lot of people come to India for cost-effective surgeries.

Question 12

12) Can I avoid nephrectomy?

Accepted Answer

Generally, no. The type of problem will decide whether a nephrectomy is necessary or not. Almost all forms of kidney cancers except Lymphoma requires nephrectomy as the full procedure or part of the procedure. Your doctor is the person who will diagnose your condition and decide whether a nephrectomy will be helpful in tackling your condition. Procedures like Radiofrequency Ablation, Cryoablation, Anti-angiogenesis therapy, mTOR inhibitors therapy, and other targeted therapies, Arterial Embolization, Immunotherapy, Chemotherapy or Radiotherapy may be used to tackle cancer due to its nature or the patient’s inability to go under a surgery due to some condition.

Nephrectomy

Symptoms

Diagnosis

Treatment

Risks

After Procedure