Calculators · Urology · Classification

R.E.N.A.L. nephrometry score

Also called RENAL score, nephrometry score, Kutikov score

Standardised CT/MRI description of renal mass complexity, used to plan partial versus radical nephrectomy.

R — Radius (maximal diameter)
E — Exophytic / endophytic
N — Nearness to collecting system or sinus
A — Anterior / posterior (descriptor, no points)
L — Location relative to polar lines

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Formula and scoring

Sum of R + E + N + L (each 1–3; total 4–12). A adds a letter (a/p/x); "h" is added for hilar tumours. Example: 9ph.

Exam and ward pearls

  • Written as number plus letters, e.g. "10ah" = score 10, anterior, hilar.

When not to rely on it

  • An anatomical description for planning and reporting; it does not by itself tell you whether the mass is benign or malignant.

Source

  1. Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844-53. doi:10.1016/j.juro.2009.05.035 · PMID 19616235
  2. Kutikov A, Smaldone MC, Egleston BL, et al. Anatomic features of enhancing renal masses predict malignant and high-grade pathology: a preoperative nomogram using the RENAL nephrometry score. Eur Urol. 2011;60(2):241-8 (Table 1). doi:10.1016/j.eururo.2011.03.029 · PMID 21458155
  3. Basu S, Khan IA, Das RK, et al. RENAL nephrometry score: predicting perioperative outcomes following open partial nephrectomy. Urol Ann. 2019;11(2):187-92 (complexity bands). doi:10.4103/ua.ua_93_18 · PMID 31040606

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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