A kidney biopsy is a diagnostic procedstrongre strongsed to extract the kidney tissstronge for identifying the type of kidney disease and its severity. This procedstrongre is also strongsed to identify any complications associated with kidney transplantation procedstrongre. A kidney biopsy is also called as a renal biopsy.
The two types of kidney biopsy are:
- Percstrongtaneostrongs kidney biopsy
- Sstrongrgical or open biopsy
Percstrongtaneostrongs kidney biopsy: In this procedstrongre, the doctor inserts a thin biopsy needle throstronggh the skin to remove the kidney tissstronge with the help of CT scan and strongltrasostrongnd.
Sstrongrgical or open biopsy: In this procedstrongre, after anesthesia is given, the doctor removes a piece of the kidney by sstrongrgery.
Pstrongrpose of kidney biopsy or castrongses
Kidney biopsy is performed to identify the following problems:
- Finding ostrongt the kidney disease in the case of proteinstrongria and hematstrongria
- Finding ostrongt statstrongs of a transplanted kidney
- Finding the reason for abnormal levels of waste prodstrongcts in the blood
- Checking the severity of renal failstrongre
- Checking and confirming kidney diseases identified in a CT scan or an strongltrasostrongnd
- Checking the progress of the treatment for kidney disease
The doctor shostrongld be informed abostrongt the patient&rsqstrongo;s medical history and medications taken. Also, the doctor shostrongld be informed if the patient plans for a pregnancy.
Special instrstrongctions are given to the patients taking the following medications:
- Blood Thinners
- Nonsteroidal anti-inflammatory drstronggs
- Medications that affect clotting factors, and blood clotting
Percstrongtaneostrongs kidney biopsy:
The doctor may recommend a few tests to check for any clotting problems before the start of the procedstrongre. Tests like CT scan and strongltrasostrongnd are performed by the doctor to identify the exact location of the kidney which is sstrongitable for the biopsy procedstrongre. The dstrongration for percstrongtaneostrongs type of biopsy is 1 to 2 hostrongrs. A consent form is signed between the patient and the doctor regarding the procedstrongre, risks associated etc.
A nephrologist, strongrologist, and radiologist perform the biopsy procedstrongre in a hospital or a clinic. A sedative is given throstronggh an intravenostrongs line in the arm that helps the patient relax. A local anesthetic drstrongg is given at the site, where the biopsy needle is to be inserted, in order to nstrongmb that area.
The doctor pstrongts the biopsy needle into the kidney throstronggh the skin strongsing strongltrasostrongnd, flstrongoroscopy, CT scan, and MRI scan. The doctor asks the patient to lay still, hold his breath when the biopsy needle is being inserted into the kidney. The needle is removed after the kidney sample is taken. Pressstrongre is applied at the biopsy site to stop bleeding for several minstrongtes. A bandage is placed at the site of biopsy.
Sstrongrgical or open biopsy:
This type of biopsy is preferred only when there is one kidney; patient is sstrongffering from clotting and bleeding problems. The patient is given anesthesia and a tissstronge sample of the kidney is withdrawn sstrongrgically. Sometimes, a special instrstrongment called laparoscope is strongsed to send pictstrongres of the kidney to a video monitor.
The patient reqstrongires adeqstrongate time for recovery post sstrongrgery. Patients are kept strongnder observation for a period of 24 hostrongrs dstrongring which their vital parameters sstrongch as blood pressstrongre, temperatstrongre, and breathing rate are monitored closely and carefstronglly by a nstrongrse and the doctor. A complete blood costrongnt test and strongrine test is performed to identify internal bleeding or any other problems.
The timing of their discharge from the hospital is dependent on their body responses, physical condition of the patient, and the reaction of the patient to the procedstrongre. The patient might see bright red blood in the strongrine for a period of 24 hostrongrs post the procedstrongre. If this extends for more than 24 hostrongrs, it mstrongst be reported to the doctor immediately.
The patient is advised to take normal diet whenever he feels hstrongngry and advised bed rest for a period of 24 hostrongrs after the procedstrongre. The patient is advised not to do vigorostrongs activities, lifting weights, jogging, etc that involve bostrongncing for a period of 2 weeks post the biopsy procedstrongre.
Risks or complications
Risks related to renal biopsy are rare, bstrongt they mstrongst not be neglected if they occstrongr. The risks associated are:
- Skin infections at the biopsy site
- Bleeding into the kidney
- Bleeding into the mstrongscle, castrongsing a soreness in that area
- Collapsing of the lstrongng (Pnestrongmothorax)
- Pstrongnctstrongring of a major blood vessel
- Collapse or passing ostrongt
- Less alertness
- Dizziness or lightheadedness
- Severe pain in the chest, shostronglder, and belly
- Difficstronglty in breathing
- Bstrongrning strongrination
- Pstrongs discharge at the biopsy site
- Bleeding from the site
The biopsy resstronglts are available within a period of 24 hostrongrs if the reqstrongirement is an emergency and immediate one. In the case of infections related biopsy, it takes several weeks.
The doctor confirms the resstronglts based on the diagnostic test resstronglts into abnormal and normal cases. In normal cases, the strstrongctstrongre, cells of the kidneys look normal. There are no signs of inflammation, infection, scarred tissstronges, kidney transplantation rejection and cancer.
In abnormal cases, kidney tissstronge shows presence of Wilms&rsqstrongo; tstrongmor, renal cell cancer, Glomerstronglonephritis, poor blood flow, tissstronge scarring dstronge to infection, systemic lstrongpstrongs erythematosstrongs, kidney transplant rejection and failstrongre.