Kidney Biopsy – Indications, Procedures, Results

Renal biopsy; Biopsy – kidney

A kidney biopsy is the removal of a small piece of kidney tissue for examination. Renal biopsy is a medical procedure in which a small piece of kidney is removed from the body for examination, usually under a microscope. Microscopic examination of the tissue can provide the information needed to diagnose, monitor, or treat problems in the kidney.

A kidney biopsy is a procedure to remove a small piece of kidney tissue that can be examined under a microscope for signs of damage or disease. Your doctor may recommend a kidney biopsy — also called renal biopsy — to diagnose a suspected kidney problem

How the Test is Performed

A kidney biopsy is done in the hospital. The two most common ways to do a kidney biopsy are percutaneous and open. These are described below.

Percutaneous biopsy

  • Percutaneous means through the skin. Most kidney biopsies are done this way.
  • You may receive medicine to make you drowsy.
  • You lie on your stomach. If you have a transplanted kidney, you lie on your back.
  • The doctor marks the spot on the skin where the biopsy needle is inserted.
  • The skin is cleaned.
  • Numbing medicine (anesthetic) is injected under the skin near the kidney area.
  • The doctor makes a tiny cut in the skin. Ultrasound images are used to find the proper location. Sometimes another imaging method, such as CT , is used.
  • The doctor inserts a biopsy needle through the skin to the surface of the kidney. You are asked to take and hold a deep breath as the needle goes into the kidney.
  • If the doctor is not using ultrasound guidance, you may be asked to take several deep breaths. This allows the doctor to know the needle is in place.
  • The needle may be inserted more than once if more than one tissue sample is needed.
  • The needle is removed. Pressure is applied to the biopsy site to stop any bleeding.
  • After the procedure, a bandage is applied to the biopsy site.

Open biopsy

In some cases, your doctor may recommend a surgical biopsy. This method is used when a larger piece of tissue is needed.

  • You receive medicine (anesthesia) that allows you to sleep and be pain-free.
  • The surgeon makes a small surgical cut (incision).
  • The surgeon locates the part of the kidney from which the biopsy tissue needs to be taken. The tissue is removed.
  • The incision is closed with stitches (sutures).

After percutaneous or open biopsy, you will likely stay in the hospital for at least 12 hours. You will receive pain medicines and fluids by mouth or through a vein (IV). Your urine will be checked for heavy bleeding. A small amount of bleeding is normal after a biopsy.

Follow instructions about caring for yourself after the biopsy. This may include not lifting anything heavier than 10 pounds (4.5 kilograms) for 2 weeks after the biopsy.

How to Prepare for the Test

Tell your health care provider:

  • About medicines, you are taking, including vitamins and supplements, herbal remedies, and over-the-counter medicines
  • If you have any allergies
  • If you have bleeding problems or if you take blood-thinning medicines such as warfarin, clopidogrel, or aspirin
  • If you are or think you might be pregnant

How the Test will Feel

Numbing medicine is used, so the pain during the procedure is often slight. The numbing medicine may burn or sting when first injected.

After the procedure, the area may feel tender or sore for a few days.

You may see bright, red blood in the urine the first 24 hours after the test. If the bleeding lasts longer, tell your provider.

Why the Test is Performed

Your doctor may order a kidney biopsy if you have:

  • An unexplained drop in kidney function
  • Blood in the urine that does not go away
  • Protein in the urine found during a urine test
  • A transplanted kidney, which needs to be monitored using a biopsy

Normal Results

A normal result is when the kidney tissue shows a normal structure.

What Abnormal Results Mean

An abnormal result means there are changes in the kidney tissue. This may be due to:

  • Infection
  • Poor blood flow through the kidney
  • Connective tissue diseases such as systemic lupus erythematosus
  • Other diseases that may be affecting the kidney, such as diabetes
  • Kidney transplant rejection, if you had a transplant

Risks

Risks include:

  • Bleeding from the kidney (in rare cases, may require a blood transfusion)
  • Bleeding into the muscle, which might cause soreness
  • Infection (small risk)

FAQ

How serious is a kidney biopsy?

  • Serious complications of kidney biopsy are not common. Less serious complications can occur and can include bleeding, pain, and the development of an abnormal connection between two blood vessels (a fistula). Rare complications include infection, damage to blood vessels or other organs, or urine leaks.

Is having a kidney biopsy painful?

  • Pain. Pain at the biopsy site is common after a kidney biopsy, but it usually lasts only a few hours.

Why would a kidney biopsy be done?

  • What is a kidney biopsy? A biopsy is done to remove tissue or cells from the body for examination under a microscope. The tissue sample is removed with a needle to check for cancer or other abnormal cells. It also helps check how well the kidney is working.

How long does it take to recover from a kidney biopsy?

  • After the test, you will be told to lie down on your back for several hours. After this, you should avoid strenuous activity for about 1 week. It’s normal to feel some soreness in the area of the biopsy for 2 to 3 days.

Are you awake for a kidney biopsy?

  • The whole procedure will take about an hour. After the biopsy, you will rest in bed for several hours. If no problems develop, you will be able to go home.

What will a kidney biopsy show?

  • The kidney tissue sample can show inflammation, scarring, infection, or unusual deposits of a protein called immunoglobulin. If a person has chronic kidney disease—any condition that causes reduced kidney function over a period of time—the biopsy may show how quickly the disease is advancing.

What can you not do after a kidney biopsy?

Home care
  • Rest for 24 hours to 48 hours. …
  • Don’t drive for 24 hours to 48 hours after the procedure.
  • Don’t shower for 24 hours after the biopsy. …
  • Remove the bandage covering the biopsy site 24 hours to 48 hours after the procedure.
  • Don’t lift anything heavier than 10 pounds for 3 days to 4 days after the procedure.

Can you walk after a kidney biopsy?

  • Another doctor will look at the kidney tissue with a microscope to check for problems. After the test, you will be told to lie down on your back for several hours. After this, you should avoid strenuous activity for the next 2 to 3 days. It’s normal to feel some soreness in the area of the biopsy for 2 to 3 days.

How long are you in the hospital for a kidney biopsy?

  • After a percutaneous or open biopsy, you will likely stay in the hospital for at least 12 hours. You will receive pain medicines and fluids by mouth or through a vein (IV). Your urine will be checked for heavy bleeding. A small amount of bleeding is normal after a biopsy.

How do they take a biopsy of your kidney?

  • The most common type of biopsy is a percutaneous (through the skin) biopsy. Your doctor will make a small cut in your belly (for transplant patients) or back and use a thin needle to take out a tiny sample of your kidney tissue.

What do you wear to a kidney biopsy?

  • A kidney biopsy is done in a clinic or a hospital. You will need to take off all or most of your clothes. You will wear a gown. Before the biopsy, you may be given a sedative through an intravenous (IV) line in a vein in your arm.

What are the side effects of a kidney biopsy?

What happens after a kidney biopsy?

  • Blood in your urine after the first 24 hours.
  • Inability to urinate.
  • Fever or chills.
  • Redness, swelling, bleeding, or another drainage from the biopsy site.
  • Increased pain around the biopsy site or elsewhere.
  • Feeling faint.

Is a kidney biopsy safe?

  • Kidney biopsies are an overall safe procedure with major complications being similar to native and transplant kidney biopsies. Kidney biopsies can be safely performed as an outpatient procedure with an observation period as short as 4 h, and routine post-biopsy ultrasound may not be necessary.

What tests are done to check kidney function?

What tests do doctors use to diagnose and monitor kidney disease?

  • a blood test that checks how well your kidneys are filtering your blood, called GFR. GFR stands for glomerular filtration rate.
  • a urine test to check for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged.

What is the most accurate test for kidney function?

Urine Tests

  • A 24-hour urine test shows how much urine your kidneys produce, and can give a more accurate measurement of how well your kidney is working and how much protein leaks from the kidney into the urine in one day. Includes microscopic examination of a urine sample as well as a dipstick test.

What are the first signs of kidney problems?

Signs and symptoms of acute kidney failure may include:

  • Decreased urine output, although occasionally urine output remains normal.
  • Fluid retention causes swelling in your legs, ankles, or feet.
  • Shortness of breath.
  • Fatigue.
  • Confusion.
  • Nausea.
  • Weakness.
  • Irregular heartbeat.

What is normal creatinine for age?

  • Here are the normal values by age: 0.9 to 1.3 mg/dL for adult males. 0.6 to 1.1 mg/dL for adult females. 0.5 to 1.0 mg/dL for children ages 3 to 18 years.

What is normal kidney function by age?

eGFR gets lower as we age (even when you don’t have kidney disease)

Age (years) Average eGFR
30–39 107
40–49 99
50–59 93
60–69 85

What are normal kidney levels?

  • A GFR of 60 or higher is in the normal range. A GFR below 60 may mean kidney disease. A GFR of 15 or lower may mean kidney failure.

What color is urine when your kidneys are failing?

  • Brown, red, or purple urine
  • Kidneys make urine, so when the kidneys are failing, the urine may change. How? You may urinate less often, or in smaller amounts than usual, with dark-colored urine. Your urine may contain blood.

What blood tests indicate kidney problems?

  • Your kidney numbers include 2 tests: ACR (Albumin to Creatinine Ratio) and GFR (glomerular filtration rate). GFR is a measure of kidney function and is performed through a blood test. Your GFR will determine what stage of kidney disease you have – there are 5 stages.

Is drinking a lot of water good for your kidneys?

  • Water helps the kidneys remove wastes from your blood in the form of urine. Water also helps keep your blood vessels open so that blood can travel freely to your kidneys, and deliver essential nutrients to them.

What causes kidney damage?

  • What causes kidney failure? High blood pressure and diabetes are the two most common causes of kidney failure. They can also become damaged from physical injury, diseases, or other disorders.

What can I do to improve kidney function?

Here are some tips to help keep your kidneys healthy.
  • Keep active and fit.
  • Control your blood sugar.
  • Monitor blood pressure.
  • Monitor weight and eat a healthy diet.
  • Drink plenty of fluids.
  • Don’t smoke.
  • Be aware of the amount of OTC pills you take.
  • Has your kidney function been tested if you’re at high risk?

How do I keep my kidneys healthy?

What can I do to keep my kidneys healthy?
  • Make healthy food choices.
  • Make physical activity part of your routine.
  • Aim for a healthy weight.
  • Get enough sleep.
  • Stop smoking.
  • Limit alcohol intake link.
  • Explore stress-reducing activities.
  • Manage diabetes, high blood pressure, and heart disease.

Is there pain kidney failure?

  • Kidney failure in itself does not cause pain. However, the consequences of kidney failure may cause pain and discomfort in different parts of the body.