What is a Kidney Biopsy?
Purpose of Kidney Biopsy
- To determine the absolute etiology of renal disease and assess the extent and severity of renal disease.
- To guide treatment based on the disease.
- To follow progression of renal disease.
- To detect rejection or disease in transplant patients with kidney.
Types of Kidney Biopsy
Percutaneous Kidney Biopsy
- Percutaneous kidney biopsy is the most frequent and least painful kind. Slim needle using CT scanning or ultrasonic guidance through the skin into the kidney.
- Open Kidney Biopsy: A technique in which cut is given to create an opening to gain access into the kidney, in case of needle biopsy being risky or unsafe.
- Transjugular Kidney Biopsy: By placing a catheter through the jugular vein, usually in patients with a bleeding risk.
Why a Kidney Biopsy is Done?
Indications for Renal Biopsy
- Unexplained Hematuria: Excess or recurrent Blood in urine kidney biopsy without any identifiable cause.
- Proteinuria: Eliminating excess protein through urine, perhaps due to renal injury.
- Decreased Kidney Function: Kidney function dropped suddenly or rapidly.
- Suspected Glomerulonephritis: Inflamed filtering units in kidneys referred to as glomeruli.
- Kidney Injury or Inflammation: To diagnose the cause of nephrotic syndrome or acute kidney injury.
- Monitoring of Transplant Function: To identify early rejection or infection after kidney transplantation.
Diagnosis of Complex Kidney Disease
How to Prepare for a Kidney Biopsy
Pre-Procedure Evaluation
- Take drug history and history of previous illnesses.
- Draw blood to check your ability to clot blood and the function of your kidneys.
- Ask about allergy especially to anesthetic or medium contrast.
- Alert you against consuming a specific drug especially thinners such as aspirin warfarin, or NSAIDs.
Day of Procedure
- Fasting: You will be instructed not to eat or consume anything to drink 6-8 hours prior to the biopsy.
- What to Wear: Loose, comfortable clothes that are easy to slip on and off and allow easy access to your lower back.
- Coordinate Transportation: Since you'll be sedated or require someone to monitor you closely afterwards, arrange with someone to take you home.
Kidney Biopsy Procedure
Step-by-Step Explanation
- Positioning: You will lie down on your side or stomach to expose your lower back where kidneys are located.
- Anesthesia: The physician shall give local anesthetic to numb the area so that you shall experience no pain.
- Imaging Guidance: The doctor employs the imaging guidance of real-time ultrasound or CT scan in an effort to locate exactly where on the kidney the biopsy needle would have to be inserted with no injury.
- Tissue Sampling: A narrow, extremely fine needle is inserted through the skin into the kidney to remove small samples of tissue. Two or three are usually removed.
- When the Needle is Removed: Pressure is applied to the area to stop bleeding, and the wound where the biopsy was removed is rinsed and bandaged.
- Monitoring: You will be watched for 4-6 hours for any immediate problem like bleeding or pain.
Duration of the Procedure
What to Expect After the Kidney Biopsy?
Immediate Post-Procedure Care
- You can feel sore or sore a bit at where the biopsy was inserted.
- Rest and reduce activity for 24-48 hours.
Look for
- Bleeding or clots in your urine that are more than usual.
- Swelling or discomfort in the biopsy area that is severe.
- Fever or chills, which is infection.
Recovery Timeline:
- Most people will recover within a week.
- Heavy lifting, high-impact sports, or collision sports must be avoided for at least one week.
- Follow-up visits should monitor your Kidney biopsy recovery and provide biopsy results.
Explanation of Kidney Biopsy Results
The difference between Normal vs. Abnormal Results
- Normal Results: Shows normal kidney tissue that is not damaged, scarred, or inflamed.
- Abnormal Results: May show:
- Kidney inflammation(e.g., glomerulonephritis).
- Chronic injury, scarring or fibrosis.
- Immunocomplex deposits.
- Transplant biopsies show evidence of rejection.
Follow-Up Based on Results
Conditions Diagnosed with Kidney Biopsy
- Glomerulonephritis: Glomerulonephritis diagnosis is the Inflammation of the immune system leading to filters in kidneys.
- Nephrotic Syndrome: Proteinuria and edema increased.
- Acute or Chronic Kidney Injury: To diagnose etiology and severity.
- Kidney Transplant Rejection: Diagnosis of rejection at an early stage by biopsy.
- Interstitial Nephritis: Inflammation of space between tubules in kidneys.
- Amyloidosis or Other Rare Diseases: Deposition of faulty proteins in kidneys and thus damage.
Kidney Biopsy vs Renal Biopsy
Price of Kidney Biopsy in Pakistan