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When a patient is exhibiting symptoms of kidney disease, whether there is something in the urine that doesn't belong, like blood or protein, or if there are other signs that the kidneys are failing, one of the most important diagnostic tests available is the kidney biopsy. This is an invasive procedure during which several small pieces of the kidney are removed for examination in the laboratory. After analysis, physicians are able to determine what the causes of the symptoms are and what the best course of treatment is.

Procedure


If your physician has ordered that a biopsy be done of your kidneys, it is probably as a result of some sign of
renal disease. Preparation for a biopsy is straightforward; patients should avoid taking blood thinners for a couple of weeks before the procedure, and many doctors suggest that they not eat for a few hours beforehand, or if they do eat, keep it to a light meal.


The biopsy itself is generally done in a hospital, though some physicians will perform it in an outpatient clinic or office. The patient is lightly sedated and laid on their stomach, which provides the best access to the kidneys. Additional local sedation is administered, and then with the help of either a guiding needle or ultrasound, the kidney is located and a spring-loaded needle is inserted - this needle removes small bits of the kidney and collects it for analysis by a pathologist.


Patients are often warned that the needle makes a clicking sound as it is collecting the tissue. In many cases, the insertion of the needle and removal of tissue may be repeated so that samples can be taken from several different areas of the kidney. Continued below....

The entire procedure usually takes less than an hour. If a patient has had a kidney transplant, they are positioned on their back rather than their front; similarly, if a patient has a bleeding disorder, the procedure may be performed as an open surgery rather than via the needle.


Results


When the tissue has been collected and the procedure is over, your kidney biopsy samples will be sent to a pathology lab. The pathologist will check to see if the cells that are examined reveal a normal structure, or if something is off.


Abnormal results can explain why you are showing symptoms of renal disease, and can identify the cause. It can also let you know if a kidney transplant is being rejected or failing. Some of the conditions that a kidney biopsy can reveal include an infection, a circulatory problem within the kidney itself, or an autoimmune or genetic condition such as lupus or polycystic kidneys.

Risks


A kidney biopsy is a very important diagnostic test, and essential for determining the presence of renal disease, but it is not without risk.


When preparing for the test, make sure that your physician is aware of any bleeding disorder you may have, and be vigilant about not taking aspirin or any blood thinners for two weeks before the procedure to avoid excess bleeding from the kidney, which can be a serious complication, or into the muscle, which can cause soreness.


As with all invasive procedures, there is always a risk of infection or a reaction to the sedative or anesthetic. After the procedure is completed, you will be asked to rest and stay on site for approximately 12 hours. Your blood and urine will be checked to make sure that you are not having any adverse effects.

Kidney Biopsy