Follow-up Care After a Nephrectomy
On this page, you will find common follow-up recommendations after a nephrectomy. Your follow-up care may look different than this information. Always follow the plan you and your care team make together.
On this page:
Specialists You May See
After surgery, you may need to visit more than just your urologist or surgeon. You may need to see other specialists to get more focused care. They may also have more experience with your unique health care situation.
Your care team will usually recommend or refer you to someone based on providers they know who care for kidney cancer patients or have a special interest in kidney health.
Medical oncologist
A medical oncologist is a doctor who specializes in treating cancer with medicines (like immunotherapy or targeted therapy). They will help decide if you need more cancer treatment after surgery.
If you need more treatment, you will see your medical oncology team often as they monitor you closely for side effects.
Even if you don’t need more treatment after surgery, you may need to see a medical oncologist once a year for close monitoring to make sure your cancer has not returned (recurred).
Nephrologist
A nephrologist is a doctor who specializes in how the kidneys function or work. Not everyone needs a nephrologist. Your primary care doctor, urologist, or surgeon may be comfortable managing your kidney care after your nephrectomy.
However, if there are signs that your remaining kidney(s) may not be working well, your care team may refer you to a nephrologist. They will help you manage your kidney health and try to slow any damage to your kidney(s).
You may see a nephrologist at least every 6 months for follow-up visits, sometimes more or less often, depending on how well your kidney(s) are working.
Cancer Treatments After Surgery
You may or may not have more cancer treatment at some point after your surgery. This may depend on the type and stage of your cancer.
You may also have scans, imaging tests, and lab work to track how well your remaining kidney(s) are doing and to look for signs of the cancer returning.
Here are common cancer treatments:
Immunotherapy
Medicines that help your immune system fight the cancer cells
Targeted Therapy
Medicines that target specific features of cancer cells to stop them from growing
Radiation Therapy
Treatment that uses high-energy radiation to kill cancer cells and shrink tumors
Ablation
A procedure other than surgery to remove or kill tumors. There are different types of ablation, such as with heat (radiofrequency or microwave ablation) or cold (cryotherapy).
Click here to learn more about kidney cancer treatments.
Cancer treatments right after surgery
Cancer treatment given shortly after surgery is called adjuvant treatment. The goal of adjuvant treatment is to kill any remaining cancer cells that may be in your body to lower the chance of the cancer coming back.
Immunotherapy is the most common adjuvant treatment. Pembrolizumab (brand name Keytruda) is a type of immunotherapy that is often used to treat clear cell RCC and sometimes other types of RCC.
If you need adjuvant treatment, your medical oncologist will discuss specific treatments for you.
Cancer treatments for recurrent cancer
The thought that your cancer could come back (recurrent cancer) is stressful. It’s normal to feel anxious about this possibility. Click here to learn more about how to cope with the fear of recurrence.
There is a chance that the cancer may come back any time in the future. It may come back in the remaining kidney(s), or it may come back in another part of your body.
It’s important to follow your care team’s recommendations for follow-up visits, scans, and tests. These can help find cancer earlier, when it is easier to treat. You should also tell your care team if you have any changes in your health or new symptoms that concern you, even if it’s been many years after your surgery.
Possible treatments for recurrent cancer
If you have recurrent cancer, you may need more treatments. The treatments you get may depend on your kidney cancer type.
If you had clear cell RCC and it comes back, you may get:
- An immunotherapy and a targeted therapy
- 2 different immunotherapies
- A targeted therapy
- Radiation therapy
- Ablation
- Surgery to remove the cancer, with or without adjuvant treatment
If you had another type of RCC and it comes back, you may get:
- An immunotherapy and a targeted therapy
- A targeted therapy
- Radiation therapy
- Ablation
- Surgery to remove the cancer
Clinical trials
You may also be able to join a clinical trial for more treatment options. A clinical trial is a type of research study that helps find new and better ways to treat diseases like cancer.
Clinical trials may offer you additional treatment options in addition to standard treatment already available and approved to treat your cancer.
For more about clinical trials, visit our clinical trials page or find current clinical trials with our digital Finder tool:
Ongoing surveillance
You may or may not get cancer treatment after a nephrectomy. Either way, you will likely have ongoing surveillance after your surgery. This means using scans and tests to watch for signs of the cancer coming back.
You will also do tests to check how well your remaining kidney(s) are working.
How often you get certain tests and scans will vary based on your health, the stage and grade of your cancer, and other factors about your tumor. Ask your care team what follow-up schedule they recommend for your situation.
Scans and imaging tests
After your nephrectomy, your care team may use these scans and imaging tests to look for signs of recurrent cancer:
CT (computed tomography) scan
A type of scan that takes x-rays from many different angles to make detailed pictures of the inside of your body. Your care team will likely use this to look for signs of cancer in your chest (lungs), abdomen (stomach area), and pelvis.
Magnetic Resonance Imaging (MRI)
A type of scan that uses radio waves, a powerful magnet, and a computer to make detailed pictures of areas inside your body. Your care team will likely use this to look for signs of cancer in your abdomen and pelvis.
Abdominal ultrasound
A type of scan that uses sound waves to make pictures of the inside of your abdomen.
About MRI and CT contrast dyes
MRI and CT scans sometimes use contrast dyes or material. This is a substance injected through an IV line into a vein in your arm or hand before a scan. While it is in your body, it helps the scan machines create better, clearer pictures to more easily find any new mass or other problems.
Most of the time, contrast dyes are easily cleared by your kidney(s). However, if your remaining kidney(s) are not working well, contrast dyes can be harmful.
Talk with your care team about if you need to avoid contrast dye after a nephrectomy.
Lab Work
After your nephrectomy, your care team will use lab work (blood and urine tests) to monitor your kidney health, such as:
Urinalysis
A urine test that looks for protein in your urine, which may be a sign of kidney damage
Blood tests
Your team will take samples of your blood to check how well your kidneys are working and your overall health. Some blood tests include:
- eGFR (estimated glomerular filtration rate) – A blood test that measures how well your remaining kidney(s) are filtering your blood
- Serum creatinine level – A blood test that measures the amount of creatinine in your blood. Creatinine is a waste product made by your muscles. Your kidneys usually filter it out of your blood and into your urine. If your remaining kidney(s) are not working well, your serum creatinine level goes up
Your care team will tell you if you need other lab work to monitor your kidney health.
Follow-up schedule for scans and lab work
These are general guidelines from the National Comprehensive Cancer Network ® (NCCN ®). Your follow-up schedule may look different and should be based on your situation based on the type, stage, grade, and other features of your cancer, as well as other aspects of your health.
If you have stage I (1) cancer
- A physical exam, a review of your medical history, and lab work to look for cancer once a year
- An abdominal CT or MRI scan 3 to 12 months after surgery, then once a year for at least the next 5 years
- An MRI is usually preferred, but your doctor will decide which option is better for you
- A chest CT scan once a year for at least the next 5 years
- Special note: if you received treatment for your cancer other than a nephrectomy, your doctor may recommend a different follow-up plan and schedule
If you have stage II (2) cancer
- A physical exam, a review of your medical history, and lab work to look for cancer once a year
- An abdominal/pelvic CT or MRI scan every 6 months for 2 years, then once a year for a total of at least 5 years
- An MRI is usually preferred, but your doctor will decide which option is better for you
- A chest CT scan once a year for at least the next 5 years
If you have stage III (3) cancer
- A physical exam, a review of your medical history, and lab work to look for cancer every 3 to 6 months for 3 years, then once a year for at least the next 5 years (may continue after 5 years depending on your doctor’s recommendation)
- An abdominal/pelvic CT or MRI scan 3 to 6 months after surgery. Then a CT, MRI, or ultrasound every 3 to 6 months for at least 3 years, then once a year for a total of at least 5 years
- Your doctor will decide which option is best for you
- A chest CT scan 3 to 6 months after surgery; then a chest CT scan every 3 to 6 months for at least 3 years; then once a year for a total of at least 5 years
- Your doctor may recommend additional tests depending on your diagnosis and any symptoms you may experience
If you have stage IV (4) cancer
- If you are taking medicine to actively treat your cancer:
- Your medical oncologist will tell you what scans and lab work you will need to do and when
- If you are not actively treating your cancer (no evidence of disease):
- Your doctor will determine the plan based on your diagnosis and any symptoms you may experience
- If you had a nephrectomy because your kidney cancer spread into your adrenal gland, your doctor will likely follow the recommendations for stage III (3) kidney cancer
*For all stages, you may do imaging scans beyond 5 years if your care team recommends it for your specific situation.
*If you get adjuvant treatment (additional treatment shortly after surgery), experts recommend that you follow the schedule for stage III (3) cancer before, during, and after treatment. This is regardless of what your cancer stage is after surgery.
References:
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Kidney Cancer V.1.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed November 5, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
Information on this page last reviewed: November, 2025