Nephrectomy
What is Nephrectomy?
A nephrectomy is a surgical procedure to remove part or all of a kidney, typically to treat kidney cancer, severe infections, trauma, or non-functioning kidneys, or to harvest a kidney for living donor transplantation. It can be performed using open or minimally invasive techniques. In India, nephrectomies are performed in urology or transplant surgery departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need Nephrectomy?
Nephrectomy is indicated for:
- Kidney cancer:
- Renal cell carcinoma (RCC, 90% of kidney cancers; 3–5 per 100,000 in India).
- Stages I–III (5-year survival: 70–90% for stage I; 50–70% for stage II–III).
- Transitional cell carcinoma (if in renal pelvis, rare).
- Benign conditions:
- Non-functioning kidney (e.g., from chronic infection, stones, or hydronephrosis).
- Severe trauma (e.g., laceration from accidents).
- Polycystic kidney disease (if symptomatic, e.g., pain, infection).
- Transplant:
- Living donor nephrectomy (healthy kidney donated; usually left kidney due to longer vein).
- Associated treatments:
- Lymph node dissection for cancer staging.
- Adjuvant therapy (e.g., immunotherapy like pembrolizumab) for advanced RCC.
- Timing:
- Performed in adults (average age 50–70 years for RCC); urgency depends on diagnosis (e.g., immediate for trauma).
The procedure aims to remove diseased tissue, preserve renal function (if partial), or facilitate transplantation, often using minimally invasive approaches to reduce recovery time.
Why Do Nephrectomy Costs Vary in India?
Costs range from ₹1 lakh to ₹3 lakh :
- Procedure Type: Laparoscopic/simple (₹1–1.5 lakh); partial/robotic (₹1.5–2.5 lakh); open/radical (₹1.5–3 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹1.5–3 lakh); lower in government hospitals (AIIMS: ₹50,000–₹1 lakh, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced urologists charge more.
- Additional Costs: Anesthesia (₹10,000–₹20,000), hospital stay (₹5,000–₹15,000/day), imaging (₹5,000–₹15,000), medications (₹5,000–₹10,000).
- Insurance: Often covered (medical necessity); confirm with your provider; donor nephrectomy may have partial coverage.
Nephrectomy Procedure
- Before Surgery Evaluation:
- Assessment:
- Imaging: CT/MRI to assess tumor size, location, and spread; renal vein involvement checked for RCC.
- Blood tests: Kidney function (creatinine, eGFR); blood sugar, clotting profile.
- Split renal function test (e.g., DMSA scan): Ensures remaining kidney function (must be >50% of total).
- Preparation: Optimize kidney function; for donors, ensure compatibility (blood type, HLA matching).
- Consent: Risks, including kidney function decline, are explained.
- Assessment:
- Surgical Techniques:
- Nephrectomy:
- Performed under general anesthesia, lasting 2–4 hours.
- Types:
- Radical nephrectomy: Removes entire kidney, adrenal gland (if involved), and surrounding tissue; for RCC.
- Partial nephrectomy: Removes tumor and margin (1 cm); preserves kidney; for small tumors (<4–7 cm) or solitary kidney.
- Simple nephrectomy: Removes kidney only; for benign conditions.
- Approaches:
- Open nephrectomy: Large incision (10–20 cm) in flank or abdomen; for large tumors or trauma.
- Laparoscopic nephrectomy: 3–4 small incisions (5–10 mm); camera and instruments used; for cancer or donors.
- Robotic nephrectomy: Similar to laparoscopic but with robotic assistance; often for partial nephrectomy.
- Process:
- Kidney isolated; renal artery and vein clamped and divided.
- Tumor/kidney removed; in partial, kidney repaired (ischemia time <30 minutes to preserve function).
- Lymph nodes sampled (for RCC staging); adrenal gland spared unless involved.
- Closure: Sutures for laparoscopic; sutures/staples for open; drain placed to prevent fluid buildup.
- Intraoperative Tools:
- Laparoscope: Visualizes kidney.
- Endoscopic clips: Secures vessels.
- Intraoperative ultrasound: Guides partial nephrectomy.
- Nephrectomy:
- After Surgery:
- Hospital stay: 2–4 days (laparoscopic); 4–7 days (open).
- Care: Monitor kidney function (creatinine); drain removed in 2–4 days; hydration to support remaining kidney.
- Pain management: Moderate pain for 3–5 days; managed with painkillers (e.g., paracetamol).
- Instructions: Avoid heavy lifting for 6–8 weeks; monitor blood pressure (remaining kidney compensates).
Recovery After Nephrectomy
- Hospital Stay: 2–4 days (laparoscopic); 4–7 days (open).
- Post-Surgery Care:
- Pain/Swelling: Moderate pain for 3–5 days; swelling resolves in 1–2 weeks.
- Activity: Avoid strenuous activity for 6–8 weeks; light activities in 1–2 weeks.
- Incision: Laparoscopic scars (small, 5–10 mm) fade in 3–6 months; open scar (10–20 cm) fades in 6–12 months.
- Kidney function: Remaining kidney compensates within weeks; creatinine stabilizes in 1–2 months.
- Diet: Hydrate well; low-sodium diet to reduce kidney strain; avoid NSAIDs long-term.
- Follow-Up:
- Visits at 1 week (check healing), 1 month, and every 3 months for 2 years (cancer recurrence risk).
- Imaging: CT at 3–6 months for RCC; kidney function tests (creatinine, eGFR) annually.
Most resume normal activities in 3–4 weeks (laparoscopic) or 4–6 weeks (open); full recovery takes 6–8 weeks. Success rate: 5-year survival for localized RCC is 90–95%; 60–70% for stage III with adjuvant therapy.
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): Hematoma near site; may need transfusion.
- Infection (2–5%): At incision site; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Urine leak (1–3%, partial): From kidney repair site; may need stent or drainage.
- Kidney function decline (5–10%): Remaining kidney may struggle (e.g., if pre-existing disease); dialysis rare (<1%).
- Injury to nearby organs (1–2%): Spleen, bowel; rare with experienced surgeons.
- Seroma (1–3%): Fluid collection; may need aspiration.
- Long-Term:
- Recurrence (10–20%, RCC): Cancer return; needs regular imaging.
- Hypertension (5–10%): From kidney loss; managed with medication.
Report fever, severe pain, decreased urine output, or swelling promptly.
Frequently Asked Questions (FAQs)
What causes the need for nephrectomy?
Kidney cancer (RCC), non-functioning kidney (e.g., infection, stones), trauma, or living donor transplant.
Can I avoid nephrectomy?
Yes, if small RCC: Ablation (e.g., RFA) or active surveillance; surgery needed for larger tumors, non-functioning kidneys, or donation.
Is nephrectomy painful?
Moderate pain for 3–5 days, managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 1–2 weeks; full recovery: 6–8 weeks; avoid strenuous activity for 6–8 weeks.
Is nephrectomy covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, decreased urine output, or swelling.
Can I live with one kidney?
Yes: 90–95% lead normal lives; remaining kidney compensates; monitor function long-term.
Lifestyle changes post-surgery?
Stay hydrated, follow low-sodium diet, avoid kidney strain (e.g., NSAIDs), and attend follow-ups.
Conclusion
Nephrectomy is a safe and effective procedure for treating kidney cancer and other conditions, with good outcomes when kidney function is preserved. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult a urologist for personalized guidance.
Looking for Best Hospitals for Nephrectomy
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
3,00,000 |
6,00,000 |
Ahmedabad |
3,50,000 |
6,50,000 |
Ajmer |
3,00,000 |
6,00,000 |
Aligarh |
3,00,000 |
6,00,000 |
Allahabad |
3,00,000 |
6,00,000 |
Amritsar |
3,25,000 |
6,25,000 |
Aurangabad |
3,25,000 |
6,25,000 |
Bangalore |
3,50,000 |
6,50,000 |
Bareilly |
3,00,000 |
6,00,000 |
Belgaum |
3,25,000 |
6,25,000 |
Bhopal |
3,25,000 |
6,25,000 |
Bhubaneswar |
3,25,000 |
6,25,000 |
Bikaner |
3,00,000 |
6,00,000 |
Chandigarh |
3,50,000 |
6,50,000 |
Chennai |
3,50,000 |
6,50,000 |
Coimbatore |
3,50,000 |
6,50,000 |
Dehradun |
3,25,000 |
6,25,000 |
Delhi |
3,50,000 |
6,50,000 |
Dhanbad |
3,00,000 |
6,00,000 |
Durgapur |
3,00,000 |
6,00,000 |
Faridabad |
3,50,000 |
6,50,000 |
Ghaziabad |
3,50,000 |
6,50,000 |
Gorakhpur |
3,00,000 |
6,00,000 |
Guntur |
3,25,000 |
6,25,000 |
Gurgaon |
3,50,000 |
6,50,000 |
Guwahati |
3,25,000 |
6,25,000 |
Gwalior |
3,00,000 |
6,00,000 |
Hyderabad |
3,50,000 |
6,50,000 |
Indore |
3,25,000 |
6,25,000 |
Jabalpur |
3,00,000 |
6,00,000 |
Jaipur |
3,50,000 |
6,50,000 |
Jalandhar |
3,25,000 |
6,25,000 |
Jamshedpur |
3,25,000 |
6,25,000 |
Jodhpur |
3,00,000 |
6,00,000 |
Kanpur |
3,00,000 |
6,00,000 |
Kochi |
3,50,000 |
6,50,000 |
Kolkata |
3,50,000 |
6,50,000 |
Kollam |
3,25,000 |
6,25,000 |
Lucknow |
3,25,000 |
6,25,000 |
Ludhiana |
3,50,000 |
6,50,000 |
Madurai |
3,25,000 |
6,25,000 |
Mangalore |
3,25,000 |
6,25,000 |
Meerut |
3,00,000 |
6,00,000 |
Moradabad |
3,00,000 |
6,00,000 |
Mumbai |
3,50,000 |
6,50,000 |
Mysore |
3,50,000 |
6,50,000 |
Nagpur |
3,25,000 |
6,25,000 |
Nashik |
3,25,000 |
6,25,000 |
Navi Mumbai |
3,50,000 |
6,50,000 |
Noida |
3,50,000 |
6,50,000 |
Patna |
3,00,000 |
6,00,000 |
Pune |
3,50,000 |
6,50,000 |
Raipur |
3,25,000 |
6,25,000 |
Rajkot |
3,25,000 |
6,25,000 |
Ranchi |
3,00,000 |
6,00,000 |
Surat |
3,50,000 |
6,50,000 |
Thane |
3,50,000 |
6,50,000 |
Vadodara |
3,25,000 |
6,25,000 |
Varanasi |
3,00,000 |
6,00,000 |
Visakhapatnam |
3,25,000 |
6,25,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.