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Kidney removal — a serious surgical procedure after which the body needs time to recover. After surgery, the entire workload of filtering the blood and removing metabolic waste products shifts to the remaining kidney. Over time, the body adapts to these changes, but how well the single kidney copes with the increased workload depends on its condition and the person's overall health. Therefore, recovery is not limited to the healing of the surgical wound but also involves regular monitoring of kidney function and certain lifestyle changes.

In this article, we will discuss how the body adapts after nephrectomy, how long the postoperative period lasts, and what difficulties may arise. We will also explain which restrictions apply to physical activity and nutrition and what recommendations should be followed to reduce the risk of complications and maintain the health of the remaining kidney.

How the Body Adapts to Functioning with One Kidney

After one kidney is removed, compensatory mechanisms are activated in the body, allowing it to maintain blood filtration, fluid and electrolyte balance, and the elimination of metabolic waste products. In particular, the volume of blood filtered through the nephrons — the functional units of kidney tissue — increases. Over time, the remaining kidney may increase slightly in size. This process is called compensatory hypertrophy.

However, this adaptation does not mean that the function of two kidneys is fully restored. The body's overall capacity to filter blood usually decreases after surgery. The extent of these changes depends on the function of both kidneys before the procedure, the patient's age, and the presence of underlying medical conditions. In particular, arterial hypertension and diabetes mellitus may increase the risk of further deterioration in the function of the remaining kidney.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), people with one kidney have an increased risk of developing protein in the urine, arterial hypertension, and a reduced glomerular filtration rate. These abnormalities may not cause noticeable symptoms for a long time, so kidney health cannot be assessed based on how a person feels alone.

To monitor the function of the remaining kidney, a surgeon may order:

  • a blood test for creatinine with calculation of the glomerular filtration rate (GFR) — helps assess how effectively the kidney filters the blood;
  • a urine albumin test — helps detect early signs of kidney tissue damage;
  • blood pressure monitoring — elevated blood pressure can be both a consequence of impaired kidney function and a factor contributing to its further deterioration.

Doctors at «Oxford Medical» recommend regularly undergoing laboratory tests and checking these indicators even in the absence of complaints. When kidney function is stable, examinations are usually performed at least once a year, but more frequent monitoring may be necessary if underlying medical conditions are present. The frequency is determined individually based on the results of previous examinations.

Postoperative Period After Kidney Removal

Postoperative Period After Kidney Removal

Recovery after kidney removal depends on the surgical technique, the patient's age, and overall health. Rehabilitation after laparoscopic surgery is usually faster than after open surgery. During the first few days, the patient remains under medical supervision and receives pain relief, while doctors monitor their condition, urine output, and kidney function.

After discharge, recovery continues at home. During this period, it is important to care for the surgical wound properly, gradually increase physical activity, and follow dietary recommendations. The time required to return to normal life is determined individually depending on the course of recovery.

What Symptoms May Occur After Kidney Removal

During the first few days after surgery, pain around the incisions, general weakness, increased fatigue, and loss of appetite may occur. After laparoscopy, shoulder pain sometimes develops due to irritation of the diaphragm by the gas used during the procedure. Abdominal bloating and constipation may also occur because of the effects of anesthesia, pain medications, and a temporary reduction in physical activity.

During normal recovery, these symptoms gradually subside. However, some symptoms may indicate postoperative complications and require medical attention.

Immediate medical attention is necessary if any of the following occur:

  • a body temperature of 38 °C or higher, chills;
  • worsening abdominal or lower back pain, especially if pain medications do not help;
  • pronounced redness, swelling, or purulent discharge from the surgical wound;
  • a significant decrease in urine output or an inability to urinate;
  • repeated vomiting that makes it impossible to drink normally;
  • pain or swelling in one leg, which may indicate thrombosis.

Sudden shortness of breath, chest pain, or loss of consciousness require emergency medical attention.

Doctors at «Oxford Medical» warn that it is important not to try to relieve unusual symptoms independently with medication. In particular, some nonsteroidal anti-inflammatory drugs may adversely affect kidney function. Therefore, even commonly used painkillers after surgery must be discussed with a doctor.

What a Scar Looks Like After Kidney Removal

The size and location of postoperative scars depend on the surgical technique. After laparoscopic surgery, several small marks from the punctures and a separate, larger incision through which the organ was removed usually remain. After open surgery, a longer scar forms on the abdomen, side, or lower back.

During the first few weeks, the scar may be pink, reddish, somewhat firm, or raised above the surface of the skin. Mild swelling, numbness, or a feeling of tightness may sometimes persist around the incision. Over time, the scar gradually becomes softer, lighter, and less noticeable. The final appearance of the scar usually develops over 6–18 months, sometimes longer.

Doctors at «Oxford Medical» note that proper surgical wound healing requires following wound care recommendations, avoiding picking at scabs, and not using cosmetic products until the wound has completely closed. It is also advisable to protect this area from sunlight to prevent persistent pigmentation.

If the scar becomes increasingly painful, discharge appears, or a noticeable bulge develops around the incision, a medical examination is necessary. These changes may indicate an infection or the formation of an incisional hernia.

Physical Activity After Kidney Removal

Physical activity is resumed gradually after surgery. Usually, medical staff help the patient get up and start walking within the first 24 hours if there are no contraindications. Early mobilization improves blood circulation, reduces the risk of blood clots, and helps restore bowel function.

According to Cleveland Clinic, strenuous physical activity and lifting objects weighing more than 4.5 kg should generally be avoided for at least six weeks after nephrectomy. Restrictions may last longer after open surgery.

Approximate stages of returning to physical activity:

Period Recommended Activity
First few days Short walks in the hospital or at home, gradually increasing walking time
1–2 weeks Gentle walks and light daily activities without physical strain
3–6 weeks Gradually increasing walking duration and daily activities without lifting heavy objects
After 6 weeks Gradually returning to exercise after a medical examination and provided there are no contraindications

These time frames are approximate. After open surgery or in the presence of complications, recovery may take 8–12 weeks or longer.

Doctors at «Oxford Medical» recommend not rushing back to strength training, running, or exercises that place significant strain on the abdominal muscles. Premature physical activity may cause pain, interfere with tissue healing, or increase the risk of an incisional hernia. Exercise intensity should only be increased after receiving a doctor's approval.

Nutrition After Kidney Removal

During the first few days after surgery, eating is resumed gradually, taking bowel function and overall well-being into account. Initially, the doctor may recommend easily digestible meals in small portions. As appetite and digestion recover, the diet is gradually expanded.

Thereafter, the diet should be balanced and provide the body with essential nutrients without placing excessive strain on the kidney. If kidney function is preserved, a strict therapeutic diet is usually unnecessary. However, some eating habits should be reconsidered.

Main recommendations:

  • limit salt — reduce the consumption of salty snacks, smoked foods, sausages, canned foods, and ready-made sauces;
  • consume moderate amounts of protein — avoid excessive consumption of large portions of meat, protein shakes, and high-protein diets;
  • include vegetables, fruits, and whole-grain products — they provide the body with fiber, vitamins, and minerals;
  • maintain adequate fluid intake — drink regularly throughout the day unless the doctor has prescribed individual restrictions;
  • limit ultra-processed foods — they often contain excessive amounts of salt, saturated fats, and food additives.

At the same time, foods rich in potassium or phosphorus should not be eliminated from the diet without medical advice. Such restrictions are mainly necessary for certain kidney function disorders and are prescribed based on examination results.

Special attention should be paid to fluid intake. There is no universal amount of water suitable for everyone with one kidney. The amount required depends on body weight, physical activity, ambient temperature, and the presence of underlying medical conditions. Excessive fluid intake does not improve kidney function and may be dangerous under certain conditions.

Living with One Kidney: Restrictions and Recommendations

Living with One Kidney: Restrictions and Recommendations

After completing rehabilitation, most people can return to their usual lifestyle. However, preserving the function of the remaining kidney requires special attention. Even when feeling well, it is important to avoid factors that may cause kidney damage and to treat diseases affecting the urinary system promptly.

Main recommendations for everyday life:

  • manage chronic diseases — maintain blood pressure and blood glucose levels within individual target ranges, especially in the presence of hypertension or diabetes mellitus;
  • use medications cautiously — avoid self-medication with nonsteroidal anti-inflammatory drugs, which may adversely affect blood flow to the kidneys;
  • prevent injuries — discuss with a doctor the possibility of participating in boxing, wrestling, other contact sports, and activities involving a high risk of blows to the lower back;
  • avoid dehydration — especially during hot weather, excessive sweating, vomiting, or diarrhea, when the body loses fluids rapidly;
  • treat urinary tract infections promptly — do not ignore burning during urination, frequent urges to urinate, lower back pain, or fever;
  • quit smoking — smoking adversely affects blood vessels and may accelerate the deterioration of kidney function.

If the organ was removed because of a malignant tumor, further follow-up should include monitoring for possible disease recurrence. The examination schedule is determined according to the tumor stage and the results of histological examination. The doctor may order additional investigations, including ultrasound, CT, or MRI.

If new complaints arise or examination results worsen, a urologist consultation is necessary. If needed, the patient is also referred to a nephrologist to assess the function of the remaining kidney and adjust treatment.

Living with one kidney does not necessarily involve significant restrictions in everyday activities. It is important to monitor kidney function regularly, avoid additional risks, and follow medical recommendations to maintain good health for many years.

The information in this article is provided for informational purposes only and is not intended as instructions for self-diagnosis or self-treatment. If symptoms of a disease occur, you should consult a doctor.

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