Nephrectomy: Purpose, Types, Procedure, Recovery and Risks
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is a nephrectomy?
A nephrectomy is surgery to remove part or all of one kidney, most often to treat a kidney tumor. A partial nephrectomy removes the diseased part; a radical nephrectomy removes the whole kidney. Most people stay in the hospital one to five days and resume normal activities six weeks later. You can live a full life with one healthy kidney. [1]
What the research says
Keeping part of the kidney protects kidney function, but with more surgical complications. A pooled analysis of 15 studies with 5,056 people with larger kidney tumors found that kidney function dropped less after a partial nephrectomy than after a radical one, and overall survival was better (hazard ratio 0.77), although complications after surgery were about twice as likely (odds ratio 2.09). (Huang et al., Frontiers in Oncology, 2021) [2]
Removing the whole kidney raises the chance of reduced kidney function. Across 31 studies with 51,866 people, a radical nephrectomy was linked to a 3.39 times higher rate of new kidney function below an eGFR of 60, and a partial nephrectomy was linked to 19% fewer cardiovascular events, with no difference in end-stage kidney disease. (Ochoa-Arvizo et al., Urologic Oncology, 2023) [3]
Keyhole surgery means less pain for kidney donors. A review of 13 randomized trials with 1,280 living kidney donors found that laparoscopic removal needed less pain medicine and a shorter hospital stay than open surgery, with no overall difference in complications, and only 1.02% of laparoscopic operations had to switch to open surgery. (Kourounis et al., Cochrane Database of Systematic Reviews, 2024) [4]
Key takeaways
A nephrectomy removes part (partial) or all (radical) of one kidney. [1]
The most common reason is a kidney tumor, but it is also done for infections, a nonworking kidney, other kidney diseases or injuries, and kidney donation. [1]
Surgery is done through one larger open incision or several small laparoscopic or robotic cuts. [1]
Most people stay in the hospital one to five days and return to normal activities about six weeks after surgery. [1]
One healthy kidney can usually do all the work your body needs. [1]
What is a nephrectomy used for?
A nephrectomy is surgery to remove a kidney, usually to treat a tumor. If you have cancer or kidney disease, it can be a lifesaving procedure. [1] Tens of thousands of nephrectomies are done in the U.S. each year. [1]
Most people are born with two kidneys, but you can live with only one as long as it is healthy and working well. A single healthy kidney can typically do every task your body needs it to. [1] To understand the most common reason for this surgery, read our kidney cancer guide.
What are the types of nephrectomy?
There are two main types of nephrectomy, and they differ in how much of the kidney is removed. [1]
A nephrectomy can remove part or all of a kidney through open or minimally invasive surgery.
Type | What is removed | Learn more |
Partial nephrectomy | Only the diseased or damaged part of the kidney | |
Radical nephrectomy | The entire kidney, sometimes with the adrenal gland and nearby lymph nodes | |
Nephroureterectomy | The entire kidney plus the ureter on the same side | |
Bilateral nephrectomy | Both kidneys | Needs dialysis or a kidney transplant afterward |
Source: [1]
A radical nephrectomy may be combined with a nephroureterectomy, which also removes the ureter, the tube that carries urine from the kidney to the bladder. [1] For one specific form of partial kidney removal, see our guide to heminephrectomy (partial kidney removal).
Open vs. laparoscopic or robotic surgery
Your surgeon will also choose how to reach the kidney: [1]
Open nephrectomy: One incision up to 12 inches (30 centimeters) long in your side or abdomen, without a camera. This approach is used for large tumors.
Laparoscopic or robotic-assisted nephrectomy: Several small incisions, typically 0.5 to 1 centimeter each. One incision is made larger to take the kidney out. A robot may be used to control the instruments.
Who needs a nephrectomy?
The most common reason to have a nephrectomy is to remove a kidney tumor, whether it is cancer or benign (not cancer). [1] Clear cell renal cell carcinoma is the type of kidney cancer explained in our guide to clear cell renal cell carcinoma.
A healthcare provider may also recommend a nephrectomy if: [1]
You get repeated kidney infections (pyelonephritis)
Your kidney has stopped working and is causing problems; if it is not causing problems, you can keep a nonworking kidney
You need treatment for other kidney diseases, such as polycystic kidney disease, or for a kidney injury
You are donating a healthy kidney to someone else
A kidney that shrinks and stops working well is described in our guide to the atrophic kidney. If you are thinking about giving a kidney, read our guide to living kidney donation.
How do you prepare for a nephrectomy?
Before a nephrectomy, your care team checks your health and plans the operation with you. [1]
Physical exam and blood test. Your temperature, pulse and blood pressure are checked, and a blood test confirms your blood type in case you need a transfusion. [1]
Medicines and supplements. Tell your team about every prescription, over-the-counter medicine and herbal supplement you take. NSAIDs, blood thinners and some herbal products can raise the risk of bleeding. [1]
Allergies. Mention any allergies to medicines, skin cleaners such as chlorhexidine, iodine or isopropyl alcohol, latex or foods. [1]
Fasting. Stop eating and drinking the night before surgery to lower the risk of vomiting and breathing stomach contents into your lungs. [1]
Confirm the plan. Make sure you know which kidney is being removed and which surgical approach is best for you. [1]
Plan your trip home. Arrange a ride and help at home for at least a few days after you leave the hospital. [1]
What happens during a nephrectomy?
A nephrectomy is done in the hospital by a team that includes a urologist, an anesthesiologist and nurses. You receive general anesthesia, so you are asleep, and a urinary catheter is placed to drain your bladder. [1]
The operation usually takes two to four hours.
During a laparoscopic or robotic nephrectomy, the surgeon: [1]
Makes small incisions: A camera called a laparoscope is placed through one of them.
Creates working space: Carbon dioxide gas inflates the abdomen, more ports are placed and the bowel is moved aside.
Clamps the blood vessels: The vessels that supply the kidney are closed or clamped.
Removes the kidney or tumor: Lymph nodes, the adrenal gland or the ureter are also removed if needed.
Closes the incisions: A drain may be placed, and the cuts are closed with stitches, staples or both.
During an open nephrectomy, the surgeon makes one larger incision, examines the kidney and the area around it, closes or clamps the blood vessels, removes the kidney or tumor, may place a drain and closes the incision. [1]
Nephrectomy at a glance
Item | Typical detail |
Setting | Inpatient hospital surgery |
Anesthesia | General anesthesia |
Operating time | About 2 to 4 hours, sometimes longer |
Incisions | One up to 30 cm (open) or several of 0.5 to 1 cm (laparoscopic or robotic) |
Hospital stay | About 1 to 5 days |
Light activity | After about 1 to 2 weeks |
Normal activities | About 6 weeks after surgery |
Source: [1]
What happens after a nephrectomy?
Right after surgery, your incision is covered, the removed kidney or tissue is sent to a lab for testing and you move to a recovery room. Your team treats your pain and shows you how to manage it. [1]
While you are in the hospital: [1]
Your team checks your blood pressure, blood chemistry, electrolytes and fluid levels.
You may start with liquids and avoid solid food for a day or two.
You start walking within about a day to help healing and lower the risk of blood clots.
Deep breathing exercises from your diaphragm help prevent pneumonia.
The urinary catheter usually comes out the day after surgery.
How your remaining kidney adapts
Within a few days, your remaining kidney grows larger and starts doing more work. Your provider checks how well it is working with kidney function tests about six weeks after surgery. [1] If both kidneys are removed, you will need dialysis or a kidney transplant. [1]
How long does recovery from a nephrectomy take?
Most people return to normal activities about six weeks after a nephrectomy. Recovery from open surgery takes longer than recovery from laparoscopic surgery. [1]
Recovery is gradual, and open surgery usually takes longer to heal from.
Tips for a smoother recovery: [1]
Start light activity after about one to two weeks, as your provider advises.
Avoid lifting anything heavier than 10 pounds (4.5 kilograms) and strenuous activity for at least six weeks.
Plan to return to work or school within a few weeks; physically demanding jobs may need more time off.
Eat less sodium, saturated fat and cholesterol, and drink about six to eight glasses of water a day.
Avoid high-contact sports such as hockey, wrestling, rugby, lacrosse and football.
Pain is usually strongest in the first several days and is managed with prescription or over-the-counter medicine. [1]
What are the benefits and risks of a nephrectomy?
A nephrectomy treats kidney conditions and can be lifesaving for people with kidney cancer. When it is done to donate a kidney, it can save a loved one's life. [1]
Like any major surgery, it carries risks: [1]
Risk | What it means |
Pain | Strongest in the first several days after surgery |
Bleeding | Blood loss during or after the operation |
Infection and sepsis | Germs enter the wound or body; sepsis is a severe, body-wide reaction to infection |
Anesthesia problems | Reactions or complications from general anesthesia |
Pneumonia | A lung infection after surgery |
Blood clots | Clots that can form when you move less |
Scarring | Scar tissue where the incisions heal |
Kidney injury or failure | A small risk, mainly if the remaining kidney has or develops disease |
Source: [1]
After a nephrectomy in childhood, the remaining kidney may lose some function, usually at least 25 years later and typically only mildly. Life expectancy after a nephrectomy depends on your overall health and other conditions. [1] Long-term kidney health is covered in our guide to chronic kidney disease.
When should you call a doctor after a nephrectomy?
You will have follow-up visits to check your stitches and recovery, and any drains are usually removed after a few days. If you had kidney cancer, you will usually have CT or MRI scans every 3 to 12 months for up to 10 years, along with urine tests and blood pressure checks. Kidney function tests, such as creatinine clearance and eGFR, are repeated every few years. [1]
Call 911 or contact a provider right away if you have any signs of kidney failure or sepsis. [1]
Call your provider if you notice: [1]
Shortness of breath
Changes in your urine, including protein, calcium or blood found in urine tests
Swelling in your legs, lower back or face
Leg pain
Rising blood pressure
Nausea or vomiting
Brain fog
Conclusion
A nephrectomy removes part or all of one kidney, most often to treat a tumor, and it can be lifesaving for people with kidney cancer or kidney disease. Your surgeon will choose between a partial and a radical nephrectomy, and between open and minimally invasive surgery, based on your condition. [1]
Most people go home within one to five days and return to normal activities in about six weeks. With one healthy kidney, you can usually live a full life, as long as you keep up with follow-up tests. [1]
Keep learning: Read our kidney cancer guide and our detailed guide to radical nephrectomy. To learn how to look after a single kidney, see this guide to living with a solitary kidney.
FAQ
What is a nephrectomy?
A nephrectomy is surgery to remove part or all of one kidney. It is most often done to remove a kidney tumor, and it can be lifesaving for people with cancer or kidney disease. [1]
What are the types of nephrectomy?
A partial nephrectomy removes only the diseased or damaged part of the kidney. A radical nephrectomy removes the whole kidney and may also remove the adrenal gland, nearby lymph nodes or, in a nephroureterectomy, the ureter. [1]
Why would someone need a nephrectomy?
The most common reason is a kidney tumor. Other reasons include repeated kidney infections, a nonworking kidney that causes problems, other kidney diseases such as polycystic kidney disease, kidney injuries and donating a kidney. [1]
Is a nephrectomy major surgery?
Yes. A nephrectomy is a major operation done under general anesthesia, and you stay in the hospital for one to five days afterward. [1]
How long does a nephrectomy take?
The operation usually takes two to four hours. It can take longer depending on your anatomy. [1]
How long will I be in the hospital after a nephrectomy?
Most people stay one to five days, depending on the type of surgery and other factors. You will need a ride home and help at home for at least a few days. [1]
How long is recovery after a nephrectomy?
Light activity can often start after one to two weeks, and most people return to normal activities about six weeks after surgery. Recovery from open surgery takes longer than from laparoscopic surgery. [1]
Can you live a normal life with one kidney?
Yes. You can live with one kidney as long as it is healthy and working well. Within a few days of surgery, the remaining kidney grows larger and takes on more of the work. [1]
What are the risks of a nephrectomy?
Risks include pain, bleeding, infection, sepsis, anesthesia problems, pneumonia, blood clots, scarring and kidney injury or failure. Kidney failure is a small risk, mainly if the remaining kidney has or develops disease. [1]
What should I avoid after a nephrectomy?
Avoid lifting more than 10 pounds (4.5 kilograms) and strenuous activity for at least six weeks. Over the long term, avoid high-contact sports such as football, hockey, rugby, lacrosse and wrestling. [1]
When should I call a doctor after a nephrectomy?
Call 911 or your provider right away for signs of kidney failure or sepsis. Call your provider for shortness of breath, urine changes, swelling in your legs, lower back or face, leg pain, rising blood pressure, nausea, vomiting or brain fog. [1]
How do I prepare for a nephrectomy?
You'll have a physical exam and a blood test to confirm your blood type, and you should tell your team about every medicine, supplement and allergy, since NSAIDs, blood thinners and some herbal products raise bleeding risk [1]. Stop eating and drinking the night before, confirm which kidney is being removed, and arrange a ride home and help at home for a few days [1].
Does a nephrectomy hurt, and what anesthesia is used?
You receive general anesthesia, so you're asleep for the two- to four-hour operation [1]. Pain is usually strongest in the first several days and is managed with prescription or over-the-counter medicine [1].
Related Reading
Single-Port Surgery: Uses, Benefits and Recovery explains single-port surgery.
References
Cleveland Clinic. Nephrectomy: Purpose, Procedure, Risks & Results. Cleveland Clinic. Last updated December 18, 2024. https://my.clevelandclinic.org/health/procedures/nephrectomy
Huang R, Zhang C, Wang X, et al. Partial Nephrectomy Versus Radical Nephrectomy for Clinical T2 or Higher Stage Renal Tumors: A Systematic Review and Meta-Analysis. Front Oncol. 2021;11:680842. PMID 34178668. https://doi.org/10.3389/fonc.2021.680842
Ochoa-Arvizo M, García-Campa M, Santos-Santillana KM, et al. Renal functional and cardiovascular outcomes of partial nephrectomy versus radical nephrectomy for renal tumors: a systematic review and meta-analysis. Urol Oncol. 2023;41(3):113-124. PMID 36642639. https://doi.org/10.1016/j.urolonc.2022.11.024
Kourounis G, Tingle SJ, Hoather TJ, et al. Robotic versus laparoscopic versus open nephrectomy for live kidney donors. Cochrane Database Syst Rev. 2024;5(5):CD006124. PMID 38721875. https://doi.org/10.1002/14651858.CD006124.pub3
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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