Having a Kidney Biopsy: A Guide for Patients

 

What is a Kidney Biopsy?

  • A biopsy of the kidney is a procedure to obtain a sample of tissue from the kidney.

  • It is an important procedure that allows your doctor to accurately diagnose your kidney disease.

  • The information gained from the biopsy will help your doctor to provide you with the most effective treatment.

How is it done?

Kidney biopsies are performed in the X-ray department. You will be lying face down on a bed. The doctor will see your kidney with an ultrasound (sound waves) machine. The doctor will mark the correct site for the biopsy. You will be given an anaesthetic to numb the skin at the biopsy site. A tiny cut is made into the skin at the marked site. The doctor will ask you to take a deep breath while he or she inserts the needle into the edge of your kidney. You will then be asked to hold your breath. A sample is taken and the needle is removed. Two to three sample may be taken. Pressure is then applied to the biopsy site to stop any bleeding and a bandage is applied. You must lie on your back for approximately 6 hours after the biopsy. You must stay in the hospital overnight.

How Should I Prepare?

It is very important to avoid medication that may thin your blood at least one week before the biopsy. Common medications which can thin your blood include warfarin, aspirin, clopidogrel (Plavix) and a variety of other medications called non-steroidal anti-inflammatory agents which include ibuprofen (Brufen), diclofenac (Difene / Voltarol) and mefanamic acid (Ponstan / Mefac). These medications are often given for arthritis pain or headaches. Please let your doctor know early if you have taken or think you may have taken any of these medications or if another doctor prescribed them.

Be prepared to stay over night.

What Can Go Wrong?

The primary risk is bleeding, because the kidney receives a large blood supply. Risks include:

  1. Visible blood in the urine for 2-3 days (about 1 in 20 biopsies)

  2. A possibility that we don’t get enough kidney tissue to make an exact diagnosis. This may mean repeating the biopsy (about 1 in 20 biopsies).

  3. Bleeding severe enough to require transfusion (uncommon – about 1 in 200 biopsies)

  4. The formation of an abnormal communication (Arteriovenous fistula) between the artery and vein (rarely a significant problem).

  5. Bleeding severe enough to require surgery (about 1 in 1000 biopsies). In very rare cases this can include require removal of the kidney (about 1 in 10,000 biopsies)

What Should I Do To Get Well?

You will need to lie flat in bed for 6 hours. After that, if you are well you may sit up in bed. If you live within 30 minutes of CUH you may be discharged that evening to rest at home. Otherwise you will remain in hospital overnight. The reason for the staying in bed is to prevent bleeding around the kidney. For four weeks after the biopsy you will need to avoid vigorous activities such as heavy lifting or running.

Your doctor may be able to tell you something about your kidney biopsy within several days but final results take 2-3 weeks