Introduction

A kidney biopsy is a procedure to remove a small piece of kidney tissue that can be examined under a miroscope for signs of damage or disease.

Your doctor may recommend a kidney biopsy also called renal biopsy to diagnose a suspected kidney problem. It may also be used to see how serious a kidney condition is, or to monitor treatment for kidney disease. You may also need a kidney biopsy if you've had a kidney transplant that's not working properly.

Importance

• Diagnose a kidney problem that can't otherwise be identified
• Help develop treatment plans based on the kidney's condition
• Determine how quickly kidney disease is progressing
• Determine the extent of damage from kidney disease or another disease
• Evaluate how well treatment for kidney disease is working
• Monitor the health of a transplanted kidney or find out why a transplanted kidney isn't working properly

Risks

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.

During the procedure

During the biopsy, you'll be awake and lie on your abdomen or your side, depending on which position allows best access to your kidney. For a biopsy of a transplanted kidney, most people lie on their backs.

A percutaneous biopsy includes these steps:

• With an ultrasound probe, your doctor identifies exactly where to insert the needle. In some cases, a CT scan may be used instead of ultrasound.
• Your doctor marks your skin, cleans the area and applies a numbing medication (local anesthetic).
• Your doctor makes a small incision where the needle will go in and uses the ultrasound device to guide the needle into your kidney.
• You may be asked to hold your breath as your doctor collects a sample using a spring-loaded instrument. You may feel a "pop" or pressure and hear a sharp clicking noise.
• Your doctor may need to insert the needle several times often through the same incision to get enough tissue.
• Your doctor removes the needle and places a small bandage on the incision.

After the procedure

• 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.

Conclusion

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John Robert                               
Assistant Managing Editor

Journal of Kidney Treatment and Diagnosis