A biopsy is a procedure performed to remove tissue or cells from the body for examination under a microscope. During a kidney biopsy, tissue samples are removed with a special needle to determine if cancer or other abnormal cells are present, or to determine how well the kidney is working.
There are two types of kidney biopsies:
A kidney biopsy may be performed to:
There may be other reasons for recommending a kidney biopsy.
As with any surgical procedure, complications can occur.
Kidney biopsy is performed with the aid of ultrasound technology. Therefore, the risk for radiation exposure is low. If pregnant or suspect may be pregnant, should notify doctor.
Kidney biopsy may be contraindicated in persons with an active kidney infection, certain bleeding conditions, uncontrolled hypertension (high blood pressure), or with only one functioning kidney.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
A kidney biopsy is done in the hospital. The two most common ways to do a kidney biopsy are percutaneous and open. These are described below.
In some cases, your doctor may recommend a surgical biopsy. This method is used when a larger piece of tissue is needed.
After percutaneous or open biopsy, you will likely stay in the hospital for at least 12 hours. You will receive pain medicines and fluids by mouth or through a vein (IV). Your urine will be checked for heavy bleeding. A small amount of bleeding is normal after a biopsy.
Follow instructions about caring for yourself after the biopsy. This may include not lifting anything heavier than 10 pounds for 2 weeks after the biopsy.
Before the procedure:
During the procedure
A kidney biopsy may be performed on an outpatient basis or as part of your stay in a hospital. The kidney biopsy may be performed in a procedure room, in a hospital bed, or in the radiology department. Procedures may vary depending on your condition and your doctor’s practices.
Generally, a kidney needle biopsy follows this process:
After the procedure
Your recovery process will vary depending on the type of procedure performed and your doctor’s practices. You may be taken to the recovery room for observation if your procedure was done in a procedure room or in the radiology department. Once your blood pressure, pulse, and breathing are stable and you are alert, you may be taken to a hospital room or discharged to your home.
You will be asked to lie on your back for several hours. A nurse will check your urine for signs of bleeding. You may have blood tests to monitor for internal bleeding. You may be discharged later the same day or the next day.
The biopsy site may be tender or sore for several days after the biopsy. Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Notify your doctor to report any of the following:
You may resume your usual diet unless instructed differently. Your doctor may ask you to rest for a day or two and to avoid strenuous physical activity for several days. You should not perform any type of “bouncing” activities, such as jogging, aerobics, playing tennis, or horseback riding for a couple of weeks to prevent bleeding of the biopsy site.
Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.
A renal biopsy is the removal of a small piece of kidney tissue for examination.
How the Test Will Feel
Numbing medicine is used, so the pain during the procedure is often slight. The numbing medicine may burn or sting when first injected.
After the procedure, the area may feel tender or sore for a few days.
You may see bright, red blood in the urine the first 24 hours after the test. If the bleeding lasts longer, tell your health care provider.
A normal value is when the kidney tissue shows normal structure.
An abnormal result means there are changes in the kidney tissue. This may be due to:
Some kidney problems can often be found with blood and urine tests, a sonogram (an image made by ultrasound) or other special x-rays, and a physical exam rather than a biopsy. But in some patients with certain types of kidney disease, and those with a kidney transplant that is not working well, a correct diagnosis can only be made with a kidney biopsy.
Specific reasons to do a kidney biopsy include:
A kidney biopsy may also help to find:
Your healthcare provider should explain the reasons for 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.
The risks of kidney biopsy are very small, but they should be discussed with your healthcare provider. As in other medical and surgical procedures, certain complications may happen even though every effort is taken to prevent them. A blood transfusion may be needed if serious bleeding occurs. Rarely, surgery may be needed to fix a blood vessel that is damaged during the procedure.
For two weeks before the biopsy, you should not take aspirin and other medicines that may cause thinning of the blood. These medicines can change the way the blood clots and raise the risk of bleeding. For the same reason, you should stop taking some supplements such as fish oil. 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.
A kidney biopsy is usually done in a hospital. An overnight stay may be needed to watch for any problems. 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.
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 biopsy site is found, your skin is marked, and 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 of the kidney sample for diagnosis. When enough is taken, the needle is removed and a bandage is placed over the needle puncture site. The entire procedure, from start to finish, usually lasts about one hour. Sometimes the biopsy may take longer than an hour.
Open kidney biopsy:
Some patients should not have a percutaneous 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 a good sample to 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 bed helps to heal the site where the kidney sample 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 problems. 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.
After the kidney sample is taken, it is sent to specially trained pathologists who will read and interpret your kidney biopsy. It often takes three to five days to get the full biopsy results. In some cases, you may have a partial or full report within 24 hours or less.
THINGS TO REMEMBER
Before the biopsy:
After the biopsy:
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I came to India with a diagnosis of HSIL (High-grade Squamous Intraepithelial Lesion), doctor suggested surgery after my first biopsy results showed negative. Initially, I was afraid to undergo surgery but the doctors and nurses were extremely good and their approach made me feel like home. I would like to thank Health Travellers Worldwide (HTW) for their guidance and support throughout our stay in India.Ms. Ciyizire R Clementine, Rwanda
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After years of suffering from knee pain, I decided to undergo surgery. I heard a lot about medical facilities in India. I sought advice from Health Travellers Worldwide. They suggested me the right hospital for Knee surgery. I chose North India and I am really happy with the hospital’s services and care by the entire teamMr. Hind Abdul Amir Hassan, Iraq