Click to learn more about Kidney Biopsy
If your doctor wants you to have a kidney biopsy, here are some things you should know.
A kidney biopsy involves taking one or more tiny pieces of your kidney tissue to look at under a regular microscope and a highly specialized electron microscope.
The kidney tissue may be taken in one of two ways:
- Percutaneous (means through the skin) biopsy: This is done using a needle placed through the skin over the kidney and guided to the right place in the kidney, usually with the help of ultrasound or under CT guidance.
- Open biopsy: The kidney tissue is taken directly from the kidney during surgery.
The kidney tissue is sent to a doctor (pathologist) who looks at it using special microscopes. He or she will check for any abnormal cells or signs of disease.
Reasons for doing a kidney biopsy
Some kidney problems can often be found by blood and urine tests, a sonogram (an image made by ultrasound) or other specialized X-rays, and a physical examination rather than a biopsy. But, in some patients with certain types of kidney disease, and those with a kidney transplant that is not working properly, a correct diagnosis can only be made with a kidney biopsy.
Specific reasons to do a kidney biopsy include:
- Blood in the urine (hematuria) or protein in the urine (proteinuria)
- Abnormal blood test results
- Acute or chronic kidney disease with no clear cause
- Nephrotic syndrome (which happens when the filtering units of the kidney are damaged)
A kidney biopsy may also help to find:
- A particular disease to see if it gets better with treatment or if it is getting worse. It may also show a problem that cannot be cured but can be slowed down by other therapy.
- How much permanent damage has happened in the kidney.
- Why a transplanted kidney is not working well. It helps your doctor decide on further treatment.
- A kidney tumor.
- Other unusual or special conditions.
Your healthcare provider should explain about the kidney biopsy. You should know why it is necessary, the benefits and any risks. You will be asked to sign a consent (permission) form to make sure you are aware of any risks. Be sure you understand the risks before you sign the consent form. You may want to write down a list of questions about the biopsy.
How to get ready for the biopsy
For two weeks before the biopsy, you should not take aspirin, over-the-counter pain medicines such as ibuprofen, naproxen, Advil, Nuprin, or other medicines that may cause thinning of the blood. These medicines can change the way the blood clots and raise the risk of bleeding. Blood and urine samples are usually taken before the kidney biopsy to make sure you do not have an infection or other condition. Your doctor may also want you to change other medications before the biopsy.
You may be told to not eat or drink for eight hours before the procedure.
How the biopsy is done
A kidney biopsy is usually done in a hospital. An overnight stay may be needed to watch for any complications. You may be awake with only light sedation, or asleep under general anesthesia. You will be lying face down with a pillow under your rib cage. If the biopsy is done on a transplanted kidney, you will be lying on your back.
Percutaneous biopsy: The kidney is found using a sonogram, X-ray images, or both. Sometimes, an injection of dye into your veins may be needed to help the doctor find the kidney and important blood vessels.
Once the site for the biopsy is found, your skin is marked, then cleaned where the biopsy needle will be inserted. You will receive a local anesthetic to numb the area where the biopsy needle enters. You will be asked to take in a deep breath and hold it as the doctor puts in the needle. When the needle pushes through the skin to the kidney, you may feel a “pop” or pressure. It is important to stay still and to hold your breath (about 45 seconds or less). Sometimes two needle passes are needed to get enough tissue for diagnosis.
When enough kidney tissue is taken, the needle is removed and a bandage is placed over the needle puncture site.
Open kidney biopsy: Some patients should not have a needle biopsy because they may have a history of bleeding problems. For these patients, an open operation may be done where the surgeon can actually see the kidney to get tissue for study.
After the test
You may need to rest in bed for 12 to 24 hours after the biopsy, as directed by the doctor. Staying still on the bed helps to heal the site where the kidney tissue was taken and lessen the chance of bleeding.
Your blood pressure and pulse are checked often to look for any signs of bleeding inside your body, or other complications. Blood tests are also done. You may eat and drink fluids after the biopsy. If your blood tests, blood pressure and pulse are stable, you should be allowed to leave the hospital the next day.
Your doctor will talk to you about physical activity and things to watch for after going home from the hospital. Heavy lifting, strenuous exercise, including contact sports, and sexual intercourse should be avoided for two weeks after the biopsy.
If you had an open biopsy, be sure to ask your doctor for any specific instructions you need to follow after the surgery.
—Source: The National Kidney Foundation