What you need to know about:

Kidney Biopsy

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Overview of

Kidney Biopsy

in Thailand

Also known as a renal biopsy, a kidney biopsy is a procedure to remove a small piece of kidney tissue that can be examined under a microscope for signs of damage or disease. This helps the doctor plan the appropriate treatment for your suspected kidney problem. There are 2 methods in which your kidney can be biopsied: Percutaneous biopsy (renal needle biopsy). This is the most common type of renal biopsy. For this procedure, a doctor inserts a thin biopsy needle through the skin to remove your kidney tissue. They may use an ultrasound or CT scan to direct the needle to a specific area of the kidney. Open biopsy (surgical biopsy). For this procedure, your doctor makes a cut in the skin near the kidneys. This allows the physician to look at the kidneys and determine the area from which the tissue samples should be taken.

Goals of

Kidney Biopsy

A kidney biopsy may be performed in order to:  

-Diagnose the cause, predict the outcome, and assess the severity of kidney disease, to discover the cause for the decrease in function of the kidneys or the presence of blood or protein in the urine, or to diagnose certain diseases, such as lupus nephritis, nephritis, and glomerular disease.  

-Discover cancer in the kidneys.  

-Assess the reason for lack of kidney function or decreased kidney function after kidney transplantation.  

-Provide information for planning treatment for chronic kidney disease.

Price of

Kidney Biopsy

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Pros and cons of

Kidney Biopsy

Pros

-Allows for accurate diagnosis and prognosis of the kidney disease

Cons

-A renal biopsy carries the risk of potential internal damage to the targeted organ or nearby areas.

How it works:

Kidney Biopsy

There are 2 types of biopsies: a percutaneous biopsy and an open biopsy.    

Percutaneous biopsies

Percutaneous biopsies are also further divided into two types; a fine needle aspiration and a core needle biopsy. Typically, a percutaneous biopsy is done by a doctor and takes about an hour.  You’ll be positioned so that you are lying on your stomach. This keeps your kidneys easily accessible from your back. You may be given a pillow or towel, since you have to remain still and stay in this position for about 30 minutes. The doctor will then inject a local anesthetic into the entry site to numb the area. They will make a small incision there and insert the needle through the incision and into your kidney. Your doctor might use an ultrasound or a CT scan to direct the needle. You’ll have to take a deep breath and hold it as your physician takes the tissue sample. This may take about 30 to 45 seconds. You may feel some discomfort when the tissue sample is being extracted. If more than one tissue sample is needed, the process will be repeated several times. Each time, the needle is inserted through the same incision. You’ll have to hold your breath while each sample is retrieved. The procedure your doctor uses will determine the instrument required to remove the tissue:  

1. Fine needle aspiration biopsy. In this procedure, your doctor extracts a small tissue sample from your kidney using a small, thin needle that is attached to a syringe.  

2. Needle core biopsy. For larger tissue samples, your physician may use a needle core biopsy. In this procedure, the doctor removes a larger sample of kidney tissue using a spring-loaded needle. If you’re having a needle core biopsy, you’ll hear a loud clicking or popping sound when the tissue sample is being removed. After the sample is retrieved, pressure is applied to the biopsy site until any bleeding has stopped. A bandage will be applied over the incision site.  

Open biopsy

Depending on your physical condition and medical history, your doctor may recommend an open biopsy. Usually, you have this type of biopsy if you’ve had problems with bleeding or blood clotting in the past or if you have only one kidney. If you’re having an open biopsy, you’ll receive general anesthesia. This means you’ll be asleep throughout the procedure. While you’re unconscious, your doctor makes an incision and surgically removes a tissue sample from your kidneys. Some surgical biopsies require an incision up to five inches long. This procedure can also be performed laparoscopically. For this procedure, your doctor will make a small incision and use a laparoscope, which is a thin, lighted tube, to perform the biopsy. The laparoscope has a video camera at the end, which sends images of the kidney to a video monitor. Using a laparoscope, your physician can observe the kidney and extract the larger tissue sample through a smaller incision.

Preparation before

Kidney Biopsy

Pre - treatment

Before your kidney biopsy, you'll meet with your doctor to talk about what to expect. This is a good time to ask questions about the procedure and make sure you understand the benefits and risks.  

Medications

When you meet with your doctor, bring a list of all medications you take, including over-the-counter medications, vitamins and herbal supplements. Before your kidney biopsy, you'll be asked to stop taking medications and supplements that can increase the risk of bleeding.

These include:  Blood-thinning medications, such as warfarin (Coumadin, Jantoven), rivaroxaban (Xarelto), dabigatran (Pradaxa) or enoxaparin (Lovenox) Drugs that keep blood platelets from excessively sticking together, such as clopidogrel (Plavix) Aspirin Ibuprofen (Advil, Motrin IB, others) and other nonsteroidal anti-inflammatory drugs (NSAIDs) Certain dietary supplements, such as omega-3 fatty acids Your doctor or nurse will let you know when to stop taking these medications and supplements, and for how long. Often, these medications are stopped seven days before the procedure and then started again seven days after the procedure.  Blood and urine samples Before your biopsy, you'll have blood drawn and provide a urine sample to make sure you don't have an infection or another condition that would make the biopsy risky.  Diet You may be asked not to drink or eat for eight hours before the kidney biopsy.

Recovery after

Kidney Biopsy

Post - treatment

After the biopsy, you can expect to: Spend time in a recovery room where your blood pressure, pulse and breathing will be monitored. Have urinalysis and complete blood count tests done to check for bleeding and other complications. Rest quietly for around four to six hours. Receive written instructions about your recovery. Feel some soreness or pain at the biopsy site for a few hours. You'll be given medications to relieve pain. Most people can leave the hospital the same day, about 12 to 24 hours after the procedure. Once home, your doctor will probably recommend that you rest for another day or two. Your health care team will let you know about any activity restrictions, such as avoiding heavy lifting and strenuous exercise. Your kidney tissue goes to a lab to be examined by a doctor who specializes in diagnosing disease (pathologist). The pathologist uses microscopes and dyes to look for unusual deposits, scarring, infection or other abnormalities in the kidney tissue.

Risks & side effects

Bleeding

The most common complication of a kidney biopsy is blood in the urine. The bleeding usually stops within a few days. Bleeding that's serious enough to require a blood transfusion affects a very small percentage of people who have a kidney biopsy. Rarely, surgery is needed to control bleeding.  

Pain

Pain at the biopsy site is common after a kidney biopsy, but it usually lasts only a few hours.  

Arteriovenous fistula

If the biopsy needle accidentally damages the walls of a nearby artery and vein, an abnormal connection (fistula) can form between the two blood vessels. This type of fistula usually causes no symptoms and closes on its own.  

Others

Rarely, a collection of blood (hematoma) around the kidney becomes infected. This complication is treated with antibiotics and surgical drainage.

Another uncommon risk is development of high blood pressure related to a large hematoma.

FAQs:

Kidney Biopsy

What are the travel recommendations after my biopsy?

If you have to travel by plane after the procedure, please consult the doctor before making an arrangement. Normally, it is recommended to avoid travel for at least 24 hours after the biopsy.

What happens after the biopsy?

The tissue sample that was retrieved during your renal biopsy will be sent to a laboratory for examination. A pathologist, a doctor who specializes in disease diagnosis, examines the tissue. Your sample is analyzed under microscopes and with reactive dyes. The pathologist identifies and assesses any deposits or scars that appear. Infections and other abnormal conditions will also be detected.  The pathologist will compile the results and make a report to your doctor within a week. If the kidney tissue shows a normal structure that is free of deposits and other defects, the results are considered normal. The results of a renal biopsy are considered abnormal if there are changes in the kidney tissue. There are numerous causes for this result. Sometimes, diseases that begin in other parts of your body can cause damage to the kidneys.

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