Urology

Radical Nephrectomy

Nephrectomy has many indications, for both simple and radical approaches.

A simple nephrectomy is indicated in patients with irreversible kidney damage due to symptomatic chronic infection, obstruction, calculus disease, or severe traumatic injury. Simple nephrectomy is also indicated to treat renovascular hypertension due to noncorrectable renal artery disease or severe unilateral parenchymal damage caused by nephrosclerosis, pyelonephritis, reflux dysplasia, or congenital dysplasia of the kidney.

Tumors, multiple cysts, and congenital anomalies may also necessitate removal of a kidney.

Radical Nephrectomy focuses on the treatment of the Renal Cell Carcinoma or the RCC by removing the kidney along with the adrenal and lymph glands. RCC is the common form of kidney cancer especially in the adults.

With partial or radical Nephrectomy, the survival rate increases by at least 5 years in 70 per cent of the cases if the spread of cancer is restricted until the renal parenchyma. In the advanced stages however, the risk increases. Various surveys reveal that in around 50 per cent of the RCC cases, the tumors are incidentally detected without any significant symptoms. This is more because in the lower stages of the cancer, the tumor is small and almost insignificant.

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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

Donor nephrectomy

A healthy person with good kidney function and a low risk of certain disorders, such as high blood pressure or diabetes, is a good candidate for donating a kidney to someone who needs a transplant. A transplant recipient who receives a kidney from a living donor has a better chance of survival than a person who receives a kidney from a deceased donor.

Procedure of Radical Nephrectomy

Nephrectomy involves several processes. Partial Nephrectomy removes portion of one kidney. In simple Nephrectomy, the entire of one non-functioning kidney is replaced. Radical Nephrectomy applies to patients diagnosed with RCC in stage I, II and III (completely damaged kidney tissue).

There is both Laparoscopic and open abdominal approach to radical Nephrectomy. In laparoscopic method, four small incisions help remove the kidney and it takes little longer than open surgery. In open abdominal procedure, the adrenal gland and kidney removal is done with dissection and the healing process is slower.

Monitoring kidney function

Most people can function well with only one kidney or with one whole kidney and part of the second. You’ll likely have annual checkups to monitor the following factors related to kidney function.

Blood pressure - You’ll need careful monitoring of your blood pressure because decreased kidney function can increase blood pressure - and high blood pressure can, in turn, damage your kidney.

Protein urine levels - High protein urine levels (proteinuria) may indicate kidney damage and poor kidney function.

Waste filtration - Glomerular filtration rate is a measure of how efficiently your kidney filters waste. The test is usually performed with a sample of blood. A reduced filtration rate indicates decreased kidney function.