skip to main content

Solitary Kidney Renal Mass Nephron-Sparing — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardAcute Kidney InjurySolitary Kidney Renal Mass Nephron-SparingESENeph

A 60-year-old man with CKD G4 has a single kidney (right nephrectomy for RCC 10 years ago, no recurrence). He develops a 2 cm solid enhancing renal mass in the remaining kidney. What is the preferred surgical approach?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Nephron-sparing surgery (partial nephrectomy) to preserve maximum renal function in his solitary kidney

In a patient with a solitary kidney, preserving renal function is paramount. Nephron-sparing surgery (partial nephrectomy) is strongly preferred over radical nephrectomy for small renal masses (<7 cm, T1) to avoid dialysis dependency. EAU 2024 renal tumour guidelines recommend partial nephrectomy as the standard of care for T1 tumours in solitary kidneys. If partial nephrectomy is technically not feasible, ablative therapies (cryoablation, radiofrequency ablation) are alternatives. Active surveillance may be appropriate for small masses (<3 cm) in elderly/comorbid patients.

Reference: EAU 2024 – Renal Tumour Guidelines; NICE NG12 – Kidney Cancer