10 Tips to Prepare for Kidney Removal Surgery

Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Lorna Collier on April 30, 2020
  • Hand holds human kidney model at white body
    How to Boost Your Chances for a Better Outcome
    If your kidney removal surgery (nephrectomy for short) is not being done on an emergency basis, you should have time to prepare for it. Doctors say patients who prepare for their surgery increase their chances of having better outcomes and better recovery experiences, with less pain and less likelihood of complications. Experts suggest a variety of simple steps you can take to prepare for your kidney removal surgery.
  • doctor talking to patient
    1. Have a frank conversation with your surgeon.
    This should be done right away. Ask your doctor what type of surgical method he or she plans to use for your nephrectomy. Can the surgery be done using an open incision or by laparoscopy, which is less invasive, with a shorter recovery time? Can only part of your kidney be removed, so that kidney function can be kept intact? Consider seeking a second opinion. Be sure you don't have remaining doubts or questions that will keep you up at night as you await your operation.
  • couple-power-walking-in-park
    2. Start training your body.
    You don't have to go all ‘Rocky’ on the courthouse steps, but you should consider yourself in training—working to get your body optimally prepared for the trauma it is set to undergo. This means doing aerobic exercise every day, such as walking at least a mile, riding your bike, swimming or climbing stairs. If it's cold, walk indoors, perhaps at your gym or shopping mall. Also, be sure to eat a healthy diet, get regular and sufficient sleep, stay well-hydrated, stop smoking (even if it's only a few days before the surgery) and limit alcohol.
  • heart with stethoscope
    3. Complete presurgical tests.
    Usually a month or so before surgery, you will be asked to go to the hospital or your doctor's office to take certain tests. These may include an EKG to monitor your heart (especially if you have a history of heart problems or are experiencing symptoms like palpitations), a chest X-ray, urinalysis and some blood tests. Your doctor may order other tests, depending on your history. It's important to get these done with enough time to address any issues they may raise before the operation.
  • lab work
    4. If you are a voluntary kidney donor, expect extra testing.
    If you are planning to become a kidney donor, you will first be tested to make sure you are healthy, and don't have conditions, such as high blood pressure or diabetes, which could put you at risk for kidney failure. You'll have blood tests to see if you match a donor by blood type, and other tests to check for possible rejection risks. About two weeks before the surgery, a social worker will meet with you to make sure you still want to donate, and aren't being pressured to do so. You also may be matched with a donor mentor.
  • Senior African American male patient holding prescription bottle with doctor
    5. Stop taking certain prescription medications.
    Blood thinners, such as Coumadin and Plavix, may present a problem during surgery. Tell your doctor all medications you take. You may need to stop blood thinners in the week or so preceding your operation, because these drugs can cause excess bleeding. Your doctor may advise you to stop other prescription drugs, as well. Be sure to communicate what you are taking well before your surgery occurs (so that it has time to get out of your system).
  • Medication Over The Counter
    6. Discontinue certain over-the-counter drugs and supplements.
    Nonprescription drugs and supplements can carry surgical risks, too. Aspirin can cause bleeding, and should be stopped seven days before surgery. Nonsteroidal anti-inflammatories (NSAIDS), such as ibuprofen (Advil or Motrin) or naproxen (Aleve), also can cause bleeding. You can wait to stop these until a couple of days before surgery. The supplement vitamin E is associated with a risk of increased bleeding and should be discontinued about 10 days prior to your procedure. Your doctor may have additional instructions regarding other supplements or herbs you take. Be sure to disclose everything well before your surgical date.
  • spirometer
    7. Start breathing exercises.
    When you're in surgery and under anesthesia, you'll be put on a ventilator. Afterwards, during your kidney removal recovery period, you will need to have breathing exercises to help restore your lungs to full functionality. If you practice breathing exercises at home before surgery, you can help your lungs expand their capacity before you get to the hospital, and you'll be better prepared to do the exercises after the surgery. Your healthcare provider likely will provide you with instructions and a device to use, called an incentive spirometer.
  • Older African American woman looking at paperwork in front of laptop with concern
    8. Have advance directives ready to turn in.
    While it is extremely unlikely, surgery always carries a risk of serious complications. Advance directives are forms, such as a living will, that explain your healthcare wishes in the event complications occur and you can't make decisions for yourself. You will need to name someone who is authorized to make decisions for you. If you have a serious medical condition, your healthcare professional can help you complete a Portable Medical Order (POLST) form (see polst.org), which is an advance care plan that many states accept. Take any such forms with you when you report for surgery.
  • Ginger tea with lemon
    9. The day before surgery, switch to clear liquids.
    Typically, your physician will require you to drink only clear liquids for 24 hours before your kidney removal surgery, and nothing after midnight the night before the operation. Besides water, clear liquids include non-creamy broths that don't have any contents, such as meat or noodles; juices, except for orange or tomato; sugar-containing drinks, such as Kool-Aid or Gatorade; tea or coffee (sweeteners are okay, but cream or milk are not). Other clear solids you can eat include fruitless Jell-O, Italian ices and popsicles.
  • woman washing her hands with soap and water
    10. Use special disinfectant soap to prevent infection.
    A liquid disinfectant soap called Hibiclens is often prescribed before surgery. You will be asked to shower or clean yourself at your sink the night before and morning of your procedure, using your regular soap and shampoo, rinsing thoroughly, and then washing with Hibiclens applied to clean washcloths. Avoid getting Hibiclens on your face, eyes or head, as it is an irritant. Antibacterial soap can be used if you don't have or are allergic to Hibiclens. After washing, don't use deodorant, lotion, powder or oils. Be sure to put on clean clothing before you arrive at the hospital.
10 Tips for Kidney Removal Surgery Preparation | Nephrectomy Prep

About The Author

Lorna Collier has been reporting on health topics—especially mental health and women’s health—as well as technology and education for more than 25 years. Her work has appeared in the AARP Bulletin, Chicago Tribune, U.S. News, CNN.com, the APA’s Monitor on Psychology, and many others. She’s a member of the American Society of Journalists and Authors and the Association of Health Care Journalists.
  1. Laparoscopic Radical Nephrectomy Pre- and Postoperative Instructions. Brady Urological Institute at Johns Hopkins Medicine. https://www.hopkinsmedicine.org/brady-urology-institute/specialties/divisions-programs/minimally-invasive-surgery/kidney-cancer/laparoscopic-radical-nephrectomy.html
  2. About Your Nephrectomy or Adrenalectomy. Memorial Sloan Kettering Cancer Center.
  3. https://www.mskcc.org/cancer-care/patient-education/about-your-kidney-surgery
  4. Nephrectomy (kidney removal). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/nephrectomy/about/pac-20385165
  5. Nephrectomy. National Kidney Foundation. https://www.kidney.org/atoz/content/nephrectomy
  6. Kidney Donation Facts to Prepare You. University of Wisconsin Health. https://www.uwhealth.org/healthfacts/transplant/4530.pdf
  7. What to Expect as a Living Donor. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/transplant/programs/kidney/living_donors/expect.html
  8. Types of Advance Directives. American Cancer Society. https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-financial-and-legal-matters/advance-directives/types-of-advance-health-care-directives.html
  9. Hibiclens shower: Preventing surgical site infections. University of Iowa Hospitals & Clinics. https://uihc.org/health-topics/hibiclens-shower-preventing-surgical-site-infections
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Apr 27
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.