Kidney removal (nephrectomy)
An operation to remove all of a kidney (radical nephrectomy) or just the part containing a tumour (partial nephrectomy), most often to treat kidney cancer, sometimes for a non-cancer problem.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A nephrectomy removes all of a kidney (radical) or just the tumour-bearing part (partial), most often for kidney cancer; most people live normally with one working kidney.
- When it is done for cancer, surgery aims to remove the cancer but cannot guarantee a cure — the type, stage and completeness are confirmed only by pathology, and a multidisciplinary team guides your care.
- Where safe, surgeons try to keep kidney tissue (partial nephrectomy) and to use keyhole surgery for a quicker recovery, but the plan can change during the operation.
- Recovery commonly takes a few weeks to a few months, and you may need monitoring of the remaining kidney and follow-up scans, with further treatment for some people.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Removes the tumour, which is the main treatment for many kidney cancers caught early
A small tumour might be better suited to ablation (freezing or heating) or active surveillance in selected patients.
You are helped to get moving, eat and drink, and your pain is managed. A bladder catheter and a wound drain are usually in for a short time. Most people...
Care coordinated by a multidisciplinary team, with a clear plan for results and follow-up.
You are helped to get moving, eat and drink, and your pain is managed. A bladder catheter and a wound drain are...
Expect tiredness and some wound discomfort. Build up gentle walking, avoid heavy lifting and strenuous activity...
Energy and comfort gradually improve and many people return to normal activities and lighter work. Avoid heavy...
A follow-up appointment usually reviews your recovery and the pathology results on the removed tissue, and...
What is kidney removal (nephrectomy)?
A nephrectomy is an operation to remove all or part of a kidney. Most often it is done to treat kidney cancer, but it is sometimes needed for a kidney that is badly damaged, blocked, infected or no longer working. Most people have two kidneys and can live a normal life with one, as the remaining kidney usually does the work of both.
There are two main operations. A radical nephrectomy removes the whole kidney, and sometimes nearby tissue such as the adrenal gland or lymph nodes. A partial nephrectomy removes only the part of the kidney containing the tumour, keeping as much working kidney as possible. Where it is safe and feasible, surgeons prefer to keep kidney tissue, but partial removal is not always possible, and the plan can change to complete removal during the operation if needed.
The operation can be done by open surgery (one larger cut) or by keyhole (laparoscopic) surgery, often with robotic assistance, through several small cuts. Keyhole surgery is generally preferred where suitable, as recovery tends to be quicker. Your surgeon will explain which approach is planned and why.
When a nephrectomy is done for cancer, the aim is to remove the cancer, but surgery cannot guarantee a cure: whether the cancer is fully cleared depends on its type, size, stage and other features, which are confirmed only after the removed tissue is examined under the microscope (pathology). Decisions about your treatment are normally made by a specialist multidisciplinary team (MDT), and some people need further treatment or monitoring afterwards.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Radical nephrectomy
Removal of the whole kidney, sometimes with the adrenal gland and nearby lymph nodes. Often used when the tumour is large, central, or cannot be removed while preserving the...
Partial nephrectomy (nephron-sparing)
Removal of only the part of the kidney containing the tumour, keeping as much working kidney as possible. Preferred where safe and feasible, especially for smaller tumours.
Laparoscopic (keyhole) approach
The kidney or tumour is removed through several small cuts using a telescope and instruments, often with robotic assistance. Generally allows a quicker recovery than open...
Open approach
Removal through one larger cut in the abdomen or loin. Used for larger or more complex tumours, or where keyhole surgery is not suitable.
Preparing for your surgery
- Your case is usually discussed by a multidisciplinary team (MDT), and the surgeon will explain whether partial or total removal, and which approach, is planned.
- Expect tests beforehand, such as blood tests, scans (CT or MRI) and checks of your kidney function and general fitness.
- Tell the team about all your medicines, especially blood thinners, and any allergies or other health conditions.
- Stop smoking if you can, as it increases the risks of surgery and slows recovery.
- Arrange time off work — often several weeks — and help at home, as this is major surgery.
- You may be given anti-clot stockings and blood-thinning injections around the time of surgery to prevent clots.
- Ask what the plan is if partial removal turns out not to be possible, and what follow-up to expect.
What happens
The operation is done under general anaesthetic, sometimes with an epidural to help with pain relief afterwards. In keyhole surgery, the surgeon makes several small cuts and uses a telescope and instruments, often robot-assisted, to remove the kidney or the part containing the tumour. In open surgery, this is done through one larger cut in the abdomen or loin.
Depending on the operation, nearby tissue such as the adrenal gland or lymph nodes may also be removed. A tube (catheter) is usually placed in the bladder, and a drain may be left near the wound for a short time. The removed tissue is sent for pathology to confirm the diagnosis and other features.
The operation often takes a few hours. Afterwards you are looked after on a ward, with pain relief, and helped to get moving, eat and drink as you recover. Most people stay in hospital from a few days up to about a week, with shorter stays usual after keyhole surgery.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- A small tumour might be better suited to ablation (freezing or heating) or active surveillance in selected patients.
- You are not fit enough for major surgery and an anaesthetic, so other options are safer.
- Removing the kidney would leave too little kidney function, making preservation or another approach preferable.
- The disease is widespread, where surgery alone is not the main treatment and the MDT recommends a different plan.
Delay surgery if…
- There is an active infection that needs treating first.
- You are medically unstable or need other conditions optimised before major surgery.
- Blood-thinning medicines need managing before the operation.
- Important staging scans or MDT discussion are not yet complete.
- You need more time to understand the options and consent fully.
Alternatives to discuss
- Partial rather than total removal, to preserve kidney tissue where feasible.
- Ablation (cryotherapy or radiofrequency) for some small tumours.
- Active surveillance with scans for small or slow-growing tumours in selected patients.
- Drug or other (non-surgical) cancer treatments where surgery is not the best option.
- Treating an underlying cause for a non-cancer kidney problem instead of removing the kidney.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Removes the tumour, which is the main treatment for many kidney cancers caught early
- Provides tissue for pathology to confirm the diagnosis, type and stage
- Partial removal preserves working kidney tissue where possible
- Keyhole surgery, where suitable, generally means less pain and a quicker recovery than open surgery
- Can relieve symptoms caused by a large, bleeding or badly damaged kidney
Risks & complications
- Pain around the wound or keyhole sites for some weeks
- Temporary need for a bladder catheter and a wound drain
- Tiredness and a gradual recovery over weeks to months
- Bulging or numbness of the abdominal wall near the wound from nerve effects
- A chest infection after the operation
- Bleeding needing a blood transfusion, or occasionally further surgery
- Wound infection
- Entering the lung cavity, occasionally needing a temporary chest drain
- Urine leak from the cut edge of the kidney (after partial removal)
- Needing further (non-surgical) cancer treatment depending on the pathology
- Conversion from partial to total removal, or from keyhole to open surgery
- Injury to nearby organs such as the spleen, liver, lung, pancreas, bowel or major blood vessels
- Reduced kidney function, and very rarely the need for dialysis if the remaining kidney cannot cope
- Blood clots in the leg (DVT) or lung
- Anaesthetic, heart or circulation problems, very rarely serious
- The removed tissue turning out to be non-cancerous (benign) after all
This is major surgery, and the main specific risks are bleeding, injury to nearby organs, and an effect on kidney function — though most people manage well with one kidney. After partial removal there is also a risk of a urine leak. Sometimes a planned partial removal or keyhole operation has to be changed to a full removal or open surgery for safety. When surgery is for cancer, the pathology results guide whether the cancer was fully removed and whether any further treatment or monitoring is needed. Ask your surgeon about your kidney function, the chance of conversion, and what the follow-up plan is.
Published figures to discuss
Nephrectomy is major surgery, and the British Association of Urological Surgeons (BAUS) publishes typical frequency bands for its complications. The figures below come from BAUS-style patient information and describe how common after-effects are, not your personal risk, which depends on the tumour, the approach, your kidney function and your general health. Where the operation is for cancer, the outlook itself depends on the type and stage and is best discussed individually, not estimated from general numbers.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Bleeding needing a transfusion (and occasionally further surgery) | Occasional — between 1 in 10 and 1 in 50 patients | Major blood vessels lie close to the kidney; significant bleeding occasionally needs further surgery. | NHS — Kidney cancer: treatment and supportnhs.ukPublished figure |
| Conversion from partial to total removal, or keyhole to open surgery | Occasional — between 1 in 10 and 1 in 50 patients (varies by case) | Done for safety if the planned approach is not feasible during the operation. | NHS — Kidney cancer: treatment and supportnhs.ukPublished figure |
| Injury to nearby organs, or need for permanent dialysis | Rare — fewer than 1 in 50 patients | Most people manage well with one kidney; dialysis is a rare outcome, more likely if the remaining kidney is unhealthy. | NHS — Kidney cancer: treatment and supportnhs.ukPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery from kidney removal is gradual. It usually takes at least a couple of weeks to recover from the operation itself, with most people returning to normal activities over about 2–6 weeks and feeling fully recovered by around three months. Keyhole surgery generally allows a quicker recovery than open surgery.
- Tiredness that improves over weeks to a few months
- Wound discomfort, and some numbness or bulging near the wound
- A short period with a catheter and drain in hospital
- Gradual return of appetite and energy
- Needing to build up activity slowly and avoid heavy lifting at first
Aftercare
- Build up gentle activity and walking, but avoid heavy lifting and strenuous exercise until advised.
- Keep wounds clean and dry and watch for signs of infection.
- Take pain relief as advised and keep mobile to reduce the risk of clots.
- Stay well hydrated and eat well to support recovery; ask whether any diet or medicine changes are needed for your remaining kidney.
- Attend follow-up appointments for your results, kidney-function checks and any cancer surveillance.
- Tell future doctors and dentists that you have one kidney, as it can affect some medicines and tests.
- Know who to contact, and how, if you have concerns out of hours.
- Help at home arranged for the first weeks
- Time off work booked (often several weeks)
- Pain relief obtained and a plan for taking it
- Wound-care advice understood
- Transport arranged for the follow-up appointment
- A note that you now have one kidney, for future medical care
- The surgical or specialist nurse team's contact number saved
Scars and how they heal
Open surgery leaves one larger scar in the abdomen or loin; keyhole surgery leaves several small scars, with one slightly larger to remove the kidney. Scars are usually firm and pink at first and fade over months. Some numbness or a bulge near the wound, from effects on the nerves and muscles of the abdominal wall, can occur and may persist.
⚠ Get urgent help if…
- Increasing redness, swelling, heat or discharge from a wound, or a fever — possible infection
- Worsening abdominal or wound pain not controlled by your pain relief
- Blood in the urine that is heavy or persistent, or difficulty passing urine
- Producing much less urine than usual, or new swelling of the legs or breathlessness
- Calf pain or swelling, or sudden breathlessness or chest pain — possible clot, call 999 if breathless
- Feeling very unwell, dizzy or faint, which could suggest bleeding or infection
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is removal of the tumour or diseased kidney with a safe recovery, and — after surgery for cancer — pathology that confirms the cancer was removed. Where the kidney can be partly preserved, more kidney function is kept.
Surgery for kidney cancer aims to remove the cancer but cannot guarantee a cure. Whether it is fully cleared depends on the type, size, stage and other features of the cancer, which are confirmed by pathology after the operation. Some people need further treatment or close monitoring, and decisions are guided by a multidisciplinary team. Your surgeon and team should explain what your results mean for you and what happens next.
Most people live a normal life with one functioning kidney, though kidney function should be monitored, especially if the remaining kidney is not entirely healthy. After surgery for cancer, the outlook depends heavily on the type and stage of the cancer and is best discussed with your specialist team rather than from general figures. Long-term follow-up, often including scans, is usual to watch for any recurrence and to keep an eye on kidney function.
Combining with other procedures
A nephrectomy for cancer is part of a wider plan coordinated by a multidisciplinary team, which may include scans for staging, pathology, and sometimes further treatment such as drug therapy or, in selected cases, treatment to other sites. Where both kidneys or other organs are involved, the plan is tailored individually. Removal of the adrenal gland or lymph nodes is sometimes done at the same operation.
Follow-up & long-term care
A follow-up appointment is usually arranged for around six weeks after surgery, when the pathology results are available and recovery is reviewed. Where the operation was for cancer, longer-term follow-up with scans and kidney-function checks is arranged according to your individual plan and the multidisciplinary team's advice. Serious concerns such as heavy bleeding, infection or a suspected clot should be acted on straight away rather than left until the next appointment.
- Regular checks of kidney function, especially with one kidney or other kidney problems
- Follow-up scans and reviews for cancer surveillance as advised
- Telling future doctors and dentists that you have one kidney
- Keeping well hydrated and managing blood pressure and other conditions that affect the kidney
- Discussing any new medicines with a clinician, as some affect kidney function
Revision and secondary surgery reality
- A planned partial nephrectomy is sometimes converted to total removal during the operation for safety.
- Keyhole surgery may be converted to open surgery if needed.
- A urine leak after partial removal may need a stent or drain for a time.
- Depending on the pathology, some people need further treatment or close monitoring rather than further surgery.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Care coordinated by a multidisciplinary team, with a clear plan for results and follow-up.
- A named contact (such as a specialist nurse) and clear advice on wound care and recovery.
- Monitoring of kidney function and, for cancer, a defined surveillance schedule with scans.
- Honest discussion of pathology results and what they mean, including any further treatment.
- Clear warning signs for bleeding, infection and clots, and who to contact urgently.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether all or part of the kidney is removed, and the complexity of the tumour
- The surgical approach (open, laparoscopic, or robot-assisted)
- The surgeon's fee and the anaesthetist's fee
- The hospital or theatre and facility fee, and length of stay
- Imaging such as CT or MRI scans before and after surgery, and pathology
- Follow-up appointments, surveillance scans and kidney-function tests
- Any further treatment needed depending on the pathology
- The surgeon's and anaesthetist's fees
- The hospital or theatre and facility fee, and likely length of stay
- Imaging and pathology costs
- Follow-up appointments, surveillance scans and what is included
- What happens, and what it costs, if the operation is converted or further treatment is needed
- The policy if a complication such as bleeding or infection occurs
- The cancellation policy
On the NHS? Kidney removal for cancer is core NHS cancer care, provided free and coordinated by a multidisciplinary team; private surgery is usually chosen for shorter waits or choice of surgeon rather than because the operation is unavailable.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being promised a 'cure' for cancer, when this depends on type, stage and pathology and cannot be guaranteed.
- No discussion of the chance of conversion from partial to total, or keyhole to open.
- No explanation of the effect on kidney function and the rare risk of dialysis.
- No mention that decisions are guided by a multidisciplinary team and that further treatment may be needed.
- No clear follow-up and surveillance plan for after the operation.
Marketing red flags
- Guaranteeing a cure or a specific survival outcome for kidney cancer.
- Promoting one surgical technique as without risks or always superior regardless of the tumour.
- Downplaying that this is major surgery with a significant recovery.
- Offering surgery without clear multidisciplinary team involvement for cancer.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Can part of my kidney be saved (partial nephrectomy), or does the whole kidney need to come out?
- Will this be keyhole or open surgery, and how likely is conversion to open or to full removal?
- How is my kidney function expected to be afterwards, and what is the risk of needing dialysis?
- What will the pathology results tell us, and when will I get them?
- If it is cancer, what is the plan for further treatment or monitoring, and who decides?
- What signs of bleeding, infection or clots should I watch for, and who do I contact?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can I live normally with one kidney?
Will surgery cure my kidney cancer?
What is the difference between partial and radical nephrectomy?
Will I have keyhole or open surgery?
How long is the recovery?
Is kidney removal available on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Kidney cancer: treatment and support NHS — Kidney cancer (overview) Cambridge University Hospitals NHS — Radical removal of the kidney Cambridge University Hospitals NHS — Partial removal of the kidney Newcastle Hospitals NHS — Laparoscopic radical nephrectomy Imperial College Healthcare NHS — Recovery after a nephrectomy
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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