Kidney
Biopsy
On this page:
-
Preparation
-
Test
Procedures
-
After the Test
-
Getting the Results
-
For
More Information
A biopsy is a
diagnostic test that involves collecting
small pieces of tissue, usually through
a needle, for examination under a
microscope. A kidney biopsy can help
find a diagnosis and determine the best
course of treatment. Your doctor may
recommend a kidney biopsy if you have
any of the following conditions:
-
hematuria which is blood in your
urine
-
proteinuria which is excessive
protein in your urine
-
impaired kidney function which
causes excessive waste products in
your blood
A pathologist will
look at the kidney tissue samples to
check for unusual deposits, scarring, or
infecting organisms that would explain
your condition. The doctor may discover
that you have a condition that can be
treated and cured. If you have
progressive kidney failure, the biopsy
may indicate how quickly the disease is
advancing. A biopsy can also help
explain why a transplanted kidney is not
working properly.
Talk with your doctor
about what information might be obtained
from the biopsy and the risks involved
so that you can help make a decision
about whether a biopsy is worthwhile in
your case.
Preparation
You will have to sign
a consent form indicating that you
understand the risks involved in this
procedure, although they are very
slight. Discuss these risks thoroughly
with your doctor before you sign the
form.
Make sure your doctor
is aware of all the medicines you take
and any drug allergies you might have.
You may be told to avoid food and fluids
for 8 hours before the test. Shortly
before the biopsy, you will give blood
and urine samples to make sure you don't
have a condition that would make doing a
biopsy less desirable.
Your kidneys filter wastes and extra
water from your blood and direct them to
your bla
Test
Procedures
Kidney biopsies are
usually done in a hospital. You may be
fully awake with light sedation, or you
may be asleep under general anesthesia.
If you are awake, you will be given a
local anesthetic before the needle is
inserted.
You will lie on your
stomach to position the kidneys near the
surface of your back. If you have a
transplanted kidney, you will lie on
your back. The doctor will mark the
entry site, clean the area, and inject a
local painkiller. For a percutaneous
(through the skin) biopsy, your doctor
will use a locating needle and x-ray or
ultrasound equipment to find the right
spot and then a collecting needle to
gather the tissue. You will be asked to
hold your breath as the doctor inserts
the biopsy needle and collects the
tissue, usually for about 30 seconds or
a little longer for each insertion. Do
not exhale until you are told. You may
feel a small "popping" sensation as the
needle enters the kidney. The doctor may
need three or four passes to collect the
needed samples.
The entire procedure
usually takes about an hour, including
time to locate the kidney, clean the
biopsy site, inject the local
painkiller, and obtain the tissue
samples.
Some patients
shouldn't have a percutaneous biopsy
because they are prone to bleeding
problems. These patients may still
undergo a kidney biopsy through an open
operation in which the surgeon makes an
incision and can see the kidney to
obtain a biopsy. Another method is the
transjugular biopsy. To obtain the
tissue sample, the needle is inserted
through a catheter that enters the
patient's jugular vein at the neck. The
needle threads down through the blood
vessel to the right kidney in order to
obtain the tissue from the inside
without puncturing the outside skin of
the kidney.
After the
Test
You should lie on
your back for 12 to 24 hours. During
this time, your back will probably feel
sore. If you have a transplanted kidney,
you will lie on your stomach. You will
likely stay in the hospital overnight
after the procedure so that staff can
check your condition. You may notice
some blood in your urine for 24 hours
after the test. To detect any problems,
your team will monitor your blood
pressure and pulse, take blood samples
to measure the amount of red cells, and
examine the urine that you pass. On rare
occasions when bleeding does not stop on
its own, it may be necessary to replace
lost blood with a transfusion.
A rare complication
is infection from the biopsy procedure.
Tell your doctor or
nurse if you have any of these problems:
-
bloody urine more than 24 hours
after the test
-
inability to urinate
-
fever
-
worsening pain in the biopsy site
-
faintness or dizziness
Getting
the Results
After the biopsy, the
doctor will inspect the tissue samples
in the laboratory under one or more
microscopes, perhaps using dyes to
identify different substances that may
be deposited in the tissue. It usually
takes a few days to get the complete
biopsy results. If your case is urgent,
you may have a preliminary report within
a few hours.
Before the Test
-
Talk with your doctor to
make sure you understand the
need for a biopsy.
-
Sign a consent form.
-
Tell your doctor about any
allergies you have and
medicines you take.
-
Avoid food and fluid for 8
hours before the test.
After the Test
-
Lie on your back (stomach
for an transplanted kidney)
for 12 to 24 hours.
-
Report any problems, such as
-
bloody urine more than
24 hours after the test
-
inability to urinate
-
fever
-
worsening pain
-
faintness or dizziness
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