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Nephrectomy has many indications, for both simple and radical approaches.
A simple nephrectomy is indicated in patients with irreversible kidney damage due to symptomatic chronic infection, obstruction, calculus disease, or severe traumatic injury. Simple nephrectomy is also indicated to treat renovascular hypertension due to noncorrectable renal artery disease or severe unilateral parenchymal damage caused by nephrosclerosis, pyelonephritis, reflux dysplasia, or congenital dysplasia of the kidney.
Radical nephrectomy is the treatment of choice for localized renal cell carcinoma(RCC). In certain circumstances, radical nephrectomy is also indicated to treat locally advanced RCC and metastatic RCC.
With the advent and increasingly mainstream use of abdominal CT scanning and ultrasound imaging in recent years for various abdominal and, occasionally, chest complaints, incidental detection of RCC has increased in asymptomatic patients. Currently, more than 50% of RCC cases are detected incidentally. These tumors tend to be smaller and of lower stage, resulting in better survival rates, lower recurrence rates, and lower metastasis rates than RCC detected in symptomatic patients. Symptomatic RCC presents at a significantly higher stage and grade, and tumors are substantially more aggressive than incidentally discovered lesions, particularly at later stages.
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