Is nephrectomy indicated in ADPKD?
Indications for nephrectomy in patients with ADPKD include recurrent and/or severe infection, severe renal hemorrhage, intractable pain, and renal carcinoma.
Pretransplant nephrectomy is not usually performed, to avoid the anephric state.
Pretransplant nephrectomy should be considered only if an ADPKD kidney is sufficiently enlarged to interfere with the site of implantation of the donor kidney; in the event of frequent, recurrent infection or hemorrhage in the native kidneys; or when solid tumor cannot be ruled out.
Hand-assisted laparoscopic nephrectomy is a feasible and safe procedure compared with open nephrectomy, which is associated with significant morbidity and mortality.
