Kidney Biopsy: What to Expect Before, During & After

What is a Kidney Biopsy?

Doctors use a special needle to take small samples of kidney tissue. Doctors collect the tissue sample with this special needle. The whole procedure usually takes about half an hour to one hour.

Renal Pathologists use this key test to find cause of renal disease. They look this tissue under a microscope for diagnosis. Light microscopy, immunofluorescence and electron microscopy offers thorough assessment to detect potential abnormalities.

Why is a Kidney Biopsy Performed?

Doctors need kidney biopsy tests to diagnose specific conditions. The procedure helps to diagnose reasons for blood in urine (hematuria) or excess protein in urine (proteinuria) or cause of kidney damage.

Preparing for the Procedure

Kidney biopsy requires preparation. 

• Doctors ask you to stop using medications like blood thinners (aspirin, clopidogrel etc.) about 5-7 days before the test.

• The medical staff will take your blood to check coagulation profile before performing the biopsy.

Step-by-Step: How a Kidney Biopsy is Done

• Most patients lie on their stomach with a pillow under the ribcage, while transplant patients rest on their back. 

• The doctor gives a local anesthetic after cleaning the skin. Some patients are given sedation. 

• Your doctor uses an ultrasound to find the exact kidney location. 

• You will need to hold your breath for about 30 to 45 seconds when the needle goes into the kidney.

• Doctors will take the required tissue sample under ultrasound guidance.

• The doctor might need two or three passes to get enough tissue.

Risks and Complications

A kidney biopsy is considered safe, but it may cause some problems. These might include:

• Blood in the urine – this happens most often when seen in microscope or can be gross also which presents as red urine which mostly clears off subsequently. 

• Pain or soreness around where the biopsy was done

• Severe bleeding – though this is rare but if this doesn’t improve might require blood transfusion.

• Arteriovenous fistula – a rare issue where blood vessels form an unusual link which requires further management.

• Infection at the area where the biopsy took place

Post-Biopsy Recovery and Monitoring

The medical team will monitor you for 6-24 hours after the procedure. They check vital signs regularly and examine urine samples for blood. Most patients can return home next day after overnight observation. Recovery at home requires rest and no strenuous activities for 1-2 weeks. Your results should be ready in 5-10 days.

FAQs

1. Is a kidney biopsy painful?

   Patients experience minimal discomfort during their kidney biopsy procedure. The doctor uses local anesthetic medicine and patients usually feel just slight pain or pressure as the sample are taken. The biopsy site might feel sore for a few days afterwards. Paracetamol as pain reliever usually help manage any discomfort after the procedure.

2. How long does a kidney biopsy take?

   The whole kidney biopsy procedure, including preparation, usually takes about half an hour to one hour. The actual kidney tissue extraction needs around 10-20 minutes.

3. What are the risks of a kidney biopsy?

   Kidney biopsies are generally safe, but some risks exist:

   • Blood in the urine

   • Pain at the biopsy site

   • Hematoma

   • Infection (rare)

   • Arteriovenous fistula (an abnormal connection between blood vessels)

4. How should I prepare for the biopsy?

   You need to stop taking blood-thinning medications about 5-7 days before the procedure. Your doctor will check your blood clotting test before the procedure.

5. What happens after the procedure?

   • You will need bed rest for 12-24 hours while the healthcare team monitors your vital signs. 

   • The team checks your urine for any bleeding. 

   • You can go home once stable next day.

   • Your results should be ready in 5-10 days.