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.
There are 2 types of kidney biopsies:
1. Needle biopsy (percutaneous biopsy). After an anesthetic is given, the healthcare provider inserts the biopsy needle into the kidney to get a sample. Ultrasound or computerized tomography (CT scan) may be used to guide the needle. Most kidney biopsies are done using this technique.
2. Open biopsy . After an anesthetic is given, the healthcare provider makes an incision in the skin and surgically removes a piece of the kidney.
Kidney biopsies are done in order to
-Diagnose the cause, predict the outcome, and assess the severity of kidney disease. They also help to discover the cause for the decrease in function of the kidneys or the presence of blood or protein in the urine
-Diagnose certain diseases, such as lupus nephritis, nephritis, and glomerular disease.
-To discover cancer in the kidneys.
-To assess the reason for lack of kidney function or decreased kidney function after kidney transplantation.
-To provide information for planning treatment for chronic kidney disease.
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-Best diagnostic method to determine what is wrong with your kidneys
-A biopsy is an invasive procedure and can therefore carries some risk from the procedure such as bleeding and infections
1. 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.
2. Open 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.
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.
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.
You may be asked not to drink or eat for eight hours before the kidney biopsy.
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.
As with any procedure, complications can happen including:
-Bruising and discomfort at the biopsy site
-On-going bleeding from the biopsy site, in the urine, or inside the body
-Puncture of nearby organs or structures
-Infection near the biopsy site
-If the kidney biopsy is done with the aid of X-ray, the amount of radiation used is small. Therefore, the risk for radiation exposure is low.
-If you are pregnant or think you may be, tell your healthcare provider. Talk to your healthcare provider about the risks to the fetus from being exposed to an X-ray. Pregnancy is not always contraindication for having a kidney biopsy. It may be important to maintain the health of the mother. Special precautions may be taken to protect both the mother and the fetus during a kidney biopsy.
-You may not be able to have kidney biopsy if you have an active kidney infection, certain bleeding conditions, uncontrolled high blood pressure, or have only one working kidney.
What can abnormal results indicate?
-Kidney infection
-Restrictions or weaknesses in the flow of blood to the kidneys
-Connective tissue diseases
-Rejection of a kidney transplant
-Kidney cancer
-Complicated urinary tract infection
-Numerous other diseases that have a negative effect on kidney function
What is the difference between a needle biopsy and an open biopsy?
In a fine needle aspiration biopsy your doctor will insert a small needle that is attached to a syringe to extracts a small tissue sample from your kidney.
In a needle core biopsy, for larger tissue samples, the doctor removes a larger sample of kidney tissue using a bigger needle that is spring-loaded. If you’re having a needle core biopsy, you’ll hear a loud clicking or popping sound when the tissue sample is being removed.
Do I need a check up before the biopsy?
Yes, there are some tests that will need to be carried out before the
biopsy.
If you are an inpatient these tests will be carried out while you are on
the ward. If the plan is for you to have the biopsy as a day case you will
need to come to the Outpatients Clinic for a check up. A nurse will
contact you with a date for this check up.
When will I get the results of the biopsy?
You will be given an outpatient appointment which can be between days to weeks after the biopsy. You will then be able to discuss the results with your doctor. You may also be able to discuss any further treatment you may need.
If you are an inpatient you may get the results of the biopsy earlier.