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Kidney Biopsy

Date issued:  January 2020

For review: January 2022

Ref: B-162/Renal-I/HC/Ultrasound guided biopsy v3

PDF:  Kidney Biopsy [pdf] 438KB

Where are your kidneys?

Your kidneys are positioned in the back of the body behind the lower ribs.  Most people have two kidneys, each about 10 centimetres long.  Your kidneys act like a filter to remove waste products and extra fluid from your body.

What is a renal biopsy?

A renal (or kidney) biopsy is a test carried out by a specialist to help diagnose and treat possible kidney problems.  It can also tell your specialist how much kidney damage, if any, you have.

A renal biopsy involves a needle being passed into your kidney to take a small piece of kidney tissue for examination.  This is done under local anaesthetic. Biopsies can be taken from your own kidneys (native) or a transplant kidney if you have had a transplant.

The results from a renal biopsy will give your specialist a clearer picture of your condition.  This information is vital in helping you make decisions about your future treatment.

As the process of examining the sample taken from your kidneys takes time and first needs to be discussed in an MDT (Multi-Disciplinary Team) meeting, the results will be given to you by your consultant (or their specialist registrar) in an outpatient appointment following your biopsy.

What preparations are needed beforehand?

You will be asked to have a blood test.  This is to check that your blood is clotting normally.  The test is very important, as there is a risk of bleeding after your biopsy, if your clotting is abnormal.

Please do not take any recreational drugs or drink any alcohol before the biopsy.

If you are taking any blood thinning medications, we will advise you when to stop and restart them. You should tell us if you are taking Aspirin, Warfarin, Clopidogrel (Plavix), Rivaroxaban (Xarelto), Apixaban (Eliquis), Dabigatran (Pradaxa), Edoxban, Dipyridamole (Persantin) or any other blood thinning medication.

  

What happens on the day of my renal biopsy?

You may be asked to have nothing to eat or drink for 6 hours before the procedure, depending on whether it is to be carried out in the x-ray department or on Mayflower Ward. Please take your blood pressure medication on the morning of your procedure. If your blood pressure is too high on the day of the biopsy then your procedure may need to be cancelled and rebooked for another date.

The doctor responsible for the ward on the day will explain the procedure and will ask you to sign a consent form.  This is to make sure you understand the procedure.  Please do not hesitate to ask any questions.  The biopsy will not proceed until all your questions have been answered to your satisfaction.

You will be asked to change into a gown before the biopsy and an intravenous cannula will be inserted. The procedure normally takes around 30 minutes. If you are having a biopsy from your own kidneys, you will be asked to lie flat on your front. The doctor will perform an ultrasound scan of your kidneys; they will clean the biopsy site and inject the area with local anaesthetic.  

This will sting a little but will subside as the area becomes numb.  The doctor will then insert a needle into the numb area and obtain a small sample of the kidney.  A technician from the laboratory will examine this sample in the room to ensure that enough tissue has been taken.  A small dressing is then placed over the biopsy site. If you have a kidney transplant, the same process will take place but you will be asked to lie on your back.

What happens after the renal biopsy?

After the biopsy, you will be asked to stay in bed for approximately 6 - 8 hours. The nurses will take recordings of your pulse and blood pressure during this time.  This is to detect any early signs of bleeding. After an hour or so you will be able to have something to eat and drink.

The nurses looking after you will also check the biopsy site and ask you if you have any pain.  If so, painkillers will be prescribed for you.  It is important to tell us if you are in pain as we can make sure the right pain relief is prescribed. You may have to stay overnight, so please bring your overnight bag.

An outpatient appointment will be arranged for you to return for the results of your biopsy. You cannot drive home after the procedure so please ensure that someone can escort you home. If this is not possible please inform the ward and we will try and organise transport for you.

A small dressing will be placed over the biopsy site and can be replaced if needed.  The site should not need to be dressed after a few days.  You will be able to take a shower the day after your biopsy and a bath after 2-3 days.

Strenuous sports should be avoided for the first 10 days.  You should also avoid lifting heavy objects or shopping. With regards to returning to work, this will depend on your profession. If your job involves heavy lifting, you may be advised to take a week off.  If your job does not include lifting, you may be able to return to work 2 days after the biopsy.

 

What are the risks of having a biopsy?

The renal biopsy procedure is generally safe but there are some risks of which you should be aware:

  • Pain or discomfort at the biopsy site or the lower back area is the most common complication.  If you experience any pain or discomfort take normal pain relief within recommended dosages.
  • Blood in urine, this occurs in about 1 in 10 of cases, and nearly always settles with rest and increased fluid intake.
  • Severe damage to the kidney, requiring a blood transfusion, and possibly an operation or an additional radiological procedure to stop the bleeding (embolisation) occurs in about 1 in 500 otherwise healthy patients having a routine renal biopsy.

If complications occur it is usually within the first few hours whilst you are in hospital, but if you do experience any of the following at home, please contact Mayflower Ward immediately:

 

  • Passing blood in your urine.
  • Feeling faint or dizzy.
  • Unable to pass urine.
  • Severe abdominal or back pain.

 

Contact Numbers:

Mayflower Ward: 01752 431485

NHS 111

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