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Kidney biopsy (renal biopsy) is an invasive test. The kidney biopsy is a complex procedure and needs to be critically performed only by a nephrologist. It is a minor procedure and is done under the effect of local anesthesia. In this medical procedure, a small piece of kidney is taken and then examined under a microscope. It is done for native kidney (patient’s own kidney) or transplanted kidney (graft) biopsy.
Generally, a biopsy sample is examined under the light microscope, electron microscope, and an immunofluorescence study is done.
When to get a Kidney Biopsy?
Reasons to get a kidney Biopsy-
- A kidney biopsy may be recommended by your nephrologist to diagnose suspected kidney disease.
- It can also be used to determine the severity of a kidney problem or to track the progress of kidney disease therapy.
- If you have a kidney transplant that isn’t operating correctly or has negative blood tests or a large amount of protein present in proteinuria or suffering from glomerular damage, or renal disease with no apparent cause.
How is a Kidney Biopsy done?
Percutaneous biopsy is the most common form of biopsy. A small incision in your back and removes tiny specimens of kidney tissue using a thin, hollow needle. You will be conscious during the operation, but your nephrologist will sedate the area so that you do not experience unbearable pain.
Your nephrologist may do a laparoscopic biopsy if you have bleeding issues, a blood clot issue, or only have one kidney. Your nephrologist will be making a small cut in your abdomen and inserting a thin tube with a video camera at the tip, known as a laparoscope, to examine your kidney. During the operation, your nephrologist might use the laparoscope to check for bleeding and halt it if necessary. Through the catheter, your nephrologist can also collect tiny samples of your kidney. Anesthesia is required for a laparoscopic biopsy, which implies you will not be conscious and will not feel anything during the entire process.
How long does it take to Recover from a Kidney Biopsy?
As far as the recovery is concerned, the patient will be kept under monitoring after the biopsy is done. The time it takes for the final release will depend on the overall health of the patient, the nephrologist’s procedures, and his/her reaction to the treatment. In most cases, the patient is transported to a recovery room to relax and be observed. You’ll spend around six to eight hours lying on your back throughout this period.
Your vital indicators, such as sugar levels, temperature, pulse, and respiratory rate, are monitored. You’ll be released from the hospital after. This often occurs 12 to 24 hours following the kidney biopsy. Up to 24 hours following the biopsy, it’s usual to see bright red blood in your urine. Your nephrologist may advise you to stay in bed for 12 to 24 hours and avoid intense exercise and forceful liftings for two weeks.
What will a Kidney Biopsy Reveal?
Inflammation, scarring, infection, or atypical immunoglobulin deposits can all be seen in kidney tissue samples if a person has chronic kidney disease, which is defined as any illness that results in decreased kidney function over time. A biopsy may reveal how rapidly the disease is progressing. A biopsy can further reveal why a transplanted kidney isn’t functioning well. While the most frequent tests for kidney illness are a blood test and a urine test, a kidney biopsy can provide your nephrologist with the data on whether you have other uncommon disorders that are causing your kidneys to fail, such as focal segmental glomerulosclerosis (FSGS).
What are the Side Effects of a Kidney Biopsy?
The whole procedure is prone to certain severity, such as bleeding(requiring blood transfusion) and pain. If during the biopsy, the operation needle mistakenly harms the nearby walls of the artery and vein, the complication of the Arteriovenous fistula may rise, which is an abnormal link formed between the two blood vessels. Again, if the biopsy is not done properly, a hematoma can be infected around the kidneys.
Longer than a day after your biopsy, you find blood or blood clots in your urine. Frequent urination is quite common. Other complications are-
- Urinating causes a burning feeling.
- Suffering from high fevers
- Pain at the biopsy site is becoming worse.
- The bandage is saturated with blood or pus seeping from the biopsy site.
- Feel dizzy, feeble, or becoming pale
Internal injury to the targeted organ or surrounding regions like a liver injury can sometimes occur during a renal biopsy. The most prevalent post-biopsy complexities are macroscopic hematuria, arteriovenous fistulas, and perirenal hematomas.
Signs of Infection
If you are experiencing any of the following symptoms, see your nephrologist right away:
- More than 24 hours after your biopsy, you have bright red blood or blood clots in your urine
- Inability to urinate for a longer time
- Undergoing intense fever and chilling sensations
- Extreme swelling, bleeding, and abnormal fluid discharge from the operated site
- Constant dizziness and weakness
Is Kidney Biopsy an operation?
A kidney biopsy is generally done at a hospital as an elective procedure. If ultrasonography or CT scan is required during the operation, it can be performed in a radiology unit. Procedures may differ based on your situation and the procedures of your healthcare practitioner. So, indeed, it is a surgical procedure, and the operation follows these relevant steps-
You’ll take off your clothes and change into a hospital gown.
- An intravenous (IV) line will be inserted.
- You will be lying on your stomach so that the nephrologist may easily access your kidney. You will lie back if you have a transplanted kidney.
- An antibacterial liquid will be used to clean the skin around the biopsy site.
- When the local anesthetic is given, you will feel a syringe stick. There may be a short stinging sensation as a result of this.
- The needle may be guided into the kidney using ultrasound or X-ray.
- While the nephrologist puts the biopsy needle into the kidney, you will be instructed to breathe in and hold your breath. This stops the diaphragm from moving about and interfering with the biopsy needle’s insertion.
- When the nephrologist takes the sample, you may feel uncomfortable or pressed.
- If the nephrologist requires more than one tissue sample, there may be several punctures. If that’s the case, the puncture will be repeated.
- To halt bleeding, strong pressure will be administered to the biopsy site once the needle is removed.
- A sterile dressing or bandage will be applied.
- A sample of kidney tissue will be submitted to a lab for examination.
- Consult your nephrologist about the procedures that will be performed during your kidney biopsy.
You will be required to sign a form granting consent for the kidney biopsy to be performed. If something isn’t understood, read the form again and discuss the matter. A physical exam may be performed by your provider to ensure that you are in otherwise excellent health. You may be subjected to blood testing or other diagnostic procedures.
What are the Chances of Bleeding After a Kidney Biopsy?
After a kidney biopsy, 13 to 34 percent of patients have a chance of bleeding. Percutaneous kidney biopsy was linked to bleeding events such macroscopic hematuria (3.5%), post-biopsy hematoma (11.6%), erythrocyte transfusion (0.9%), and rarely nephrectomy (0.01 percent) or mortality (0.02 percent). Patients who get a kidney biopsy for AKD are more likely to need a blood transfusion afterward. After a biopsy using the NPS technique, AKD was linked to more post-biopsy hemorrhages. Despite the unclear mechanism, we recommend that patients with AKD who had a kidney biopsy be closely followed afterward.
Most frequent questions and answers
After Biopsy, Soreness and pain in the biopsy area are common, but it generally only lasts a few hours. For a few hours after the biopsy, you may have some stiffness or pain at the biopsy site. Painkillers will be prescribed for pain relief.
A kidney biopsy is a procedure in which a tiny sample of tissue is taken from a bodily component. The material is examined under a microscope or put through additional tests. Generally, the cost of a kidney biopsy in Delhi NCR ranges from INR 10,000 to 50,000.
Depending on the severity of the condition (varies from patient to patient), only a nephrologist can advise whether the person would need dialysis before biopsy or not.