Kidney Biopsy
During a kidney biopsy, a small piece of kidney tissue is removed so that it can be examined under a microscope for signs of damage or disease.
Purpose of a Kidney Biopsy
- Diagnose a kidney problem that can’t be identified through other methods or tests
- Inform treatment plans based on the kidney’s condition
- Determine the pace of kidney disease progression
- Determine the extent of damage from kidney disease or another illness
- Evaluate the effectiveness of treatment for kidney disease
- Monitor the health of a transplanted kidney or determine why a transplanted kidney isn’t functioning properly
Blood in the urine coming from the kidney
Protein in the urine (proteinuria) that’s excessive, rising, or accompanied by other signs of kidney disease
Problems with kidney function, leading to excessive waste products in the blood
Not every patient with these issues needs a kidney biopsy. The decision is based on the patient’s symptoms, test results, and overall health.
Risks of a Kidney Biopsy
Bleeding: It’s common for patients to have blood in the urine after a kidney biopsy. The bleeding should stop within a few days. It’s rare for patients to have serious bleeding that requires a blood transfusion.
- Pain: It’s normal to experience some minimal to moderate pain at the biopsy site for a few hours. Most patients require no pain medications after the procedure.
- Arteriovenous fistula: Patients may develop a fistula, which is an abnormal connection between two blood vessels, if the biopsy needle accidentally damages the walls of a nearby artery and vein. This type of fistula typically doesn’t cause any symptoms and closes without treatment.
- Other risks: In rare cases, a collection of blood (hematoma) around the kidney can become infected, requiring treatment with antibiotics and surgical drainage. Another uncommon risk is high blood pressure related to a large hematoma.
What to Expect During the Biopsy
During the kidney biopsy, the patient will be awake and lay on their abdomen or side, depending on which position allows best access to the kidney. Patients undergoing a biopsy of a transplanted kidney will lay on their back.
The steps of a percutaneous biopsy include:
Using an ultrasound probe, the physician will identify exactly where to insert the needle. In some cases, a CT scan will be used instead of an ultrasound.
The physician will mark the patient’s skin, cleanse the treatment area, and apply a local anesthetic.
The physician will make a small incision and insert the needle into the kidney using ultrasound guidance.
The patient may be asked to hold their breath as the doctor collects a sample using a spring-loaded instrument. As the sample is taken, the patient may feel a “pop” or pressure, and hear a sharp clicking noise.
The physician may need to insert the needle several times to get enough tissue.
The needle will be removed and the physician will place a small bandage on the incision.
