Physical Changes After a Nephrectomy

Pain or discomfort around your surgery site

This is very common after surgery. You may also have a bruise or tenderness, or nerve pain or numbness in this area. These will likely go away as your body heals. Your care team will likely give you pain medicine. Tell your care team if you are still in pain after taking the medicine. They may give you more or a different medicine, offer other ways to relieve the pain, and can check if the pain is related to another health problem.

Shoulder pain

This is very common if you had a laparoscopic surgery (surgery through tiny cuts in the skin with a thin lighted tube with a video camera). During the surgery, gas is put into your abdomen (stomach area) to help the surgeon see your kidney(s). This gas can move up into your shoulder and cause pain. This pain usually disappears as the gas is absorbed by your body.

Feeling tired and weak (fatigue)

This is very common after surgery. How long people feel tired and weak varies. You will likely feel better as your body heals. Tell your care team if it lasts more than a few weeks – they can suggest things to help you improve your strength and energy. They can also check if it is related to another health problem.

Sleeping problems

This is common after surgery. You may have trouble sleeping because of pain and discomfort or due to a medicine side effect. Stress can also affect your sleeping. Tell your care team if you have trouble sleeping – they can suggest things to help you sleep better.

Numbness or pain in your arms or body

This may happen due to how you were positioned on the operating table. This part of your body may feel “asleep” or like “pins and needles.” The longer your surgery, the higher the chance you will feel this. This usually goes away after a few days.

Infections

There is a chance you may have an infection after your surgery. Tell your care team right away if you have signs of an infection: fever, chills, or feeling sick or unwell in general. Your care team will give you medicines to treat the infection.

It is possible to get infections in different parts of your body:

Infection at your surgery site – Your surgery site can become infected, like any other cut or wound. Tell your care team if you have pain along with these signs at your surgery site:

• Red
• Swollen
• Skin feels warm or hot
• Fluid or pus

To help avoid an infection at your surgery site, keep the area clean and dry. Your surgeon will give you instructions on how to change your bandages and clean the site.

Urinary tract infections (UTIs) – UTIs can be more likely because the normal way your body makes urine gets disrupted or because you needed a catheter to help you urinate after surgery. Tell your care team if you have these signs of a UTI:

• It hurts to urinate
• You feel like you need to urinate often but only release a small amount of urine each time
• Your urine is cloudy or smelly

Chest infection – Chest infections can happen because mucus, or phlegm, can build up more easily in your lungs after a surgery, which can lead to an infection. Mucus can build up because:

• General anesthesia can keep your lungs from removing mucus as they normally do, and
• You may avoid deep breaths or coughing to clear mucus due to pain from surgery

Tell your care team if it hurts to breathe or cough – they can give you pain medicines to help you breathe and cough more easily. They can also suggest exercises and deep breathing strategies to help clear mucus from your lungs.

Blood clots (also called deep vein thrombosis, or DVT)

There is a chance you may develop a blood clot after your surgery. Blood clots are clumps of blood cells that form in your blood vessels that can block the normal flow of blood. They can form because you may be on bed rest while you recover from surgery and are not moving around as normal.

Blood clots after surgery are more likely to form in your legs. Tell your care team right away if your leg is:

• Red
• Hot
• Swollen
• Painful or tender

It is possible for blood clots to become loose and travel to your lungs and then block the blood flow in your lungs. Call 911 or go to the ER if you:

• Have trouble breathing or are short of breath
• Have chest pain
• Cough up blood
• Feel dizzy or lightheaded

To help avoid blood clots:

• You may get medicine to help keep your blood from clotting
• Ask your care team about exercises to do in bed or while resting

Bleeding

There is a chance you may bleed after your surgery. You may bleed inside your body (internally) from the blood vessels cut during your surgery, or from nearby blood vessels. After your surgery, your care team will watch you closely for signs of internal bleeding. Tell your care team if you or others see signs of blood loss, which include:

• Looking paler than normal
• Feeling short of breath
• Feeling extremely fatigued

Hernia

A hernia is when part of an organ bulges through your abdominal (stomach) muscles. Because a nephrectomy may involve cutting into your abdomen, it can weaken these muscles. This makes it easier for part of your intestine or belly fat to push through near the surgery site. Hernias can be more likely to happen if you are straining your abdominal muscles soon after your surgery.

Most hernias are not a serious medical issue, but tell your care team if you have these near your surgery site:

• A bulge or lump
• Sharp or dull pain

Tell your care team right away or go to the ER if you have:

• Sudden, severe pain
• The skin around the bulge changes color, which may require surgery

Urinary problems

There is a chance you may have urinary problems, such as trouble urinating or urinary incontinence (loss of bladder control).

Incontinence can range from a small leak to complete loss of control. This can be
more likely after a partial nephrectomy than a radical nephrectomy.

There is also a small chance that urine is unable to leave your body. This may happen if your kidney(s) becomes swollen or infected after surgery. If this happens, you may get a temporary nephrostomy tube. This is a small catheter (tube) that a doctor places directly into your kidney through the skin in your back. Your urine then drains through the tube into a bag. Most people only need this for a few days or months, but some people may need it longer.

Protect your remaining kidney(s) from injury

Physical damage to your kidney(s) can prevent it from working well. Certain activities raise the chance of kidney injury, such as these contact sports:

• Football
• Soccer
• Hockey
• Wrestling
• Boxing
• Martial arts

Talk with your care team if you want to play contact sports. It may be best to avoid these activities, but wearing protective gear, such as padding, can lower your chance of kidney injury.

Manage your blood pressure

It’s important to keep your blood pressure under control because this can cause a dangerous cycle:

• High blood pressure can damage the small blood vessels in your kidney(s)
• This can lead to chronic kidney disease (CKD)
• CKD can, in turn, raise your blood pressure

If you have high blood pressure, talk with your care team about how you can lower your blood pressure.

Avoid over-the-counter NSAIDs

NSAIDs are a type of pain medicine. Common examples are: aspirin, ibuprofen, and naproxen. These medicines can lower the amount of blood that flows through your kidney(s). This can lead to kidney injury and can make CKD worse, especially when taken for a long time or at a high dose (many pills at once). Ask your care team if you should avoid NSAIDs, and if so, what pain medicines are safe for you to take.

Eat healthy

Eating healthy is an important part of staying healthy overall. A poor diet can lead to obesity, diabetes, and high blood pressure – which can raise your chance of CKD and damage your remaining kidney(s). If your remaining kidney(s) are not working well, you may need to follow a more specific kidney-friendly eating plan. This means eating specific things to help protect your kidney health such as less salt, protein, and phosphorus. Click here to learn more about a kidney-friendly plan.

Exercise regularly

Getting regular exercise is another important part of staying healthy overall as it can improve your physical and mental wellbeing. “Regular” means exercising 30 minutes a day, 5 to 6 days a week. It doesn’t have to be going to the gym – it can be gentle exercise like walking or yoga.

Get good sleep

Good sleep is an important part of how your body grows, heals, and keeps a strong immune system. It helps improve your memory, concentration, ability to learn, mood, and emotional well-being. A good night’s sleep can even help you feel less hungry the next day.

Good sleep isn’t just about being asleep long enough – it’s also about having a consistent sleep schedule and good quality sleep. To get good quality sleep:

• Try to get 7 to 9 hours of sleep each night
• Go to sleep and wake up at consistent times (even on the weekends)
• Sleep in a dark, cool, and quiet room

Limit the amount of alcohol you drink

Your kidney(s) filter harmful substances out of your blood, including alcohol. This means the more alcohol you drink, the harder your kidney(s) have to work. Alcohol can also dehydrate you and raise your blood pressure, and this can hurt your kidney(s). Heavy drinking can raise the chance of damaging your kidney(s) and developing kidney disease. Heavy drinking is more than 3 drinks in a day (or more than 7 per week) for females, and more than 4 drinks in a day (or more than 14 per week) for males. Ask your care team if you should completely avoid alcohol, or if there is a safe amount you can drink.

Quit or avoid smoking

Smoking can lead to many types of cancers. It can also slow blood flow to your organs, like your kidney(s). This can cause kidney damage or make CKD worse, if you have it. It can be hard to quit smoking. Here are some sites to help you quit:

• SmokeFree.gov
• CDC’s How to Quit Smoking