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Complications and Risks Following Nephrectomy: A Comprehensive Review

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The surgical removal of a damaged kidney is known as nephrectomy. Read below to know more.

Written by

Hemamalini. R

Medically reviewed by

Dr. Yash Kathuria

Published At September 20, 2023
Reviewed AtSeptember 20, 2023

Introduction:

The surgical removal of a damaged kidney is known as nephrectomy. This surgical procedure is essential to alleviate symptoms and improve health, but it has certain risks and potential complications. Hence, understanding these possible problems is crucial for patients and healthcare providers to make the best decisions and ensure optimal care after the surgery.

What Is Kidney Removal?

Kidney removal, or nephrectomy, is a significant surgery performed when the kidney is damaged, no longer functioning correctly, or in kidney cancer or kidney donation cases. A nephrectomy, whether performed through open or laparoscopic surgery, has a distinct recovery period of several weeks. As with any surgery, there are potential risks of infections and complications.

What Are the Other Names for Kidney Removal?

What Are the Different Types of Kidney Removal Surgeries?

1. Partial Nephrectomy: This involves the removal of only a portion of one kidney. It is typically performed when there is a localized tumor or damage in a specific area of the kidney, and preserving the remaining healthy tissue is preferred.

2. Simple Nephrectomy: It involves the removal of the entire kidney. This procedure is mostly chosen when the kidney is severely damaged, non-functional, or affected by kidney stones or chronic infection.

3. Radical Nephrectomy: A radical nephrectomy involves the removal of the entire kidney along with the surrounding fatty tissues and the adrenal gland. Sometimes, nearby lymph nodes are removed to assess if the cancer has spread.

Why Would a Kidney Removal Procedure Be Performed?

Kidney removal, whether partial or complete, is considered a serious procedure and is typically reserved as a last resort for preserving a person's overall health. There are several reasons for kidney removal, including the following:

Damaged Kidney: Sometimes, a kidney can become damaged or not work correctly due to disease, scarring, injury, or infection. It may help relieve symptoms, prevent potential complications, and enhance the overall function of the kidney.

Donating a Kidney: Sometimes, an individual might give one of their healthy kidneys to someone who needs a new kidney. This is called a living kidney donation. It has higher success rates compared to deceased donors, and they can lead a healthy lifestyle with one kidney.

How Does Nephrectomy Affect Kidney Function?

Nephrectomy, the surgical removal of a kidney, significantly impacts kidney function. The remaining kidney compensates by increasing size, dilating blood vessels, and undergoing hypertrophy. Most people can lead a normal life with one kidney, but monitoring kidney function through regular check-ups and maintaining a healthy lifestyle is crucial. Pre-existing kidney conditions can affect the impact of nephrectomy, making follow-up care and management important.

What Are the Indications for Kidney Removal?

  • When conservative treatments are ineffective, a nephrectomy is performed for kidney cancer, advanced kidney diseases, and severe kidney trauma.

  • Nephrectomy is undertaken voluntarily by living donors to provide a healthy kidney for transplantation to a recipient with kidney failure.

  • Individual patient factors and consultation with healthcare professionals are crucial in determining the need for nephrectomy, considering the specific circumstances and risks involved.

What Are the Potential Complications Associated With Kidney Removal?

1. Bleeding:

Post-nephrectomy, the risk of bleeding looms as a notable concern. Despite careful cauterization of severed blood vessels, there remains a possibility of bleeding from these vessels or nearby tissues. In severe cases, blood transfusions or further surgery may be necessary to manage the bleeding.

2. Infection:

Surgical site infections (SSIs) can occur after nephrectomy. These infections may affect the incision site or penetrate deeper into the surgical area. Symptoms may include increased pain, redness, swelling, warmth, or drainage from the incision. Prompt medical attention and appropriate antibiotic treatment are crucial to prevent infection complications.

3. Urinary Complications:

After nephrectomy, urinary complications may arise, including urinary leakage, urinary tract infections (UTIs), or urinary retention. Urinary leakage may occur due to injury to the remaining kidney or the ureter during surgery. UTIs can develop due to the disruption of normal urinary flow or the presence of a urinary catheter. Urinary retention, the inability to empty the bladder, can also occur and may require temporary or permanent interventions, such as intermittent self-catheterization.

4. Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE):

Nephrectomy raises the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) due to factors like prolonged immobility, surgical trauma, and altered blood flow. Preventive measures like early mobilization, compression stockings, and anticoagulant medications are prescribed to mitigate these risks.

5. Hernia:

Incisional hernias can develop after nephrectomy, particularly if the surgical incision is large or there is weakness in the abdominal wall. Hernias occur when internal tissues or organs protrude through a weakened area, typically around the surgical site. Symptoms may include pain, bulging, or discomfort at the incision site. Surgical repair is usually required to alleviate symptoms and prevent further complications.

6. Chronic Kidney Disease (CKD):

Nephrectomy can impact the remaining kidney's function, potentially leading to a gradual decline over time. Regular check-ups with a physician are vital to monitor kidney function and detect potential complications. Staying connected with the healthcare provider allows patients to take proactive steps in maintaining their kidney health.

What Is the Long-Term Outlook After Nephrectomy?

The long-term outcome after nephrectomy varies depending on factors like the reason for the procedure, overall health, and remaining kidney function. Living with a single kidney often results in a healthy life as the remaining kidney adapts effectively. Kidney function typically remains stable, but regular check-ups with a healthcare provider are vital to monitor kidney health, address complications, and ensure overall well-being. Personalized advice from a healthcare professional is recommended to address individual concerns and provide an accurate long-term outlook based on specific circumstances.

Can Kidney Damage Be Prevented?

Prevention of kidney damage is possible through healthy lifestyle habits, effective management of chronic conditions like diabetes and high blood pressure, adequate hydration, responsible medication use, and regular medical monitoring to assess kidney function.

Conclusion:

As previously mentioned, kidney removal (nephrectomy) is necessary for damaged kidneys. It becomes crucial to understand the complications of this operation. Collaboration and proactive measures between patients and healthcare providers are essential in minimizing risks associated with nephrectomy. This approach greatly enhances the procedure's success and promotes the patient's well-being. Together, we conquer the challenges, embracing a journey toward healing.

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Dr. Yash Kathuria
Dr. Yash Kathuria

Family Physician

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