Renal biopsy means that a small amount of kidney tissue is extracted after that pathological and laboratory analysis is performed.
your doctor cannot decide whether your kidney is cancerous or benign, despite
all the tests. In such a case, they may want to take a small piece of your
If there is
a strong clinical suspicion that the mass in the kidney is malignant after all
diagnostic tests have been performed, the next step will be the nephrectomy
which means that all or part of your kidney is surgically removed.
kidney biopsy is performed in certain cases, this is not very common.
example, if your kidney cancer has been metastasized at the time of diagnosis,
a biopsy can be performed to identify the subtype of your cancer and select an
appropriate systemic treatment accordingly.
many functions normally performed by the kidneys in daily life. Some of them
can be listed as;
Filtering of toxic and waste materials such as urea from blood and producing the urine
Removing excess fluid and salt in the body
Ensuring the balance of acid-base and chemicals such as sodium, potassium or calcium in the body
Production and secretion of erythropoietin, a hormone stimulating red blood cell production from bone marrow
Production and secretion of calcitriol, a hormone that regulates calcium absorption and blood calcium levels
Regulation of blood pressure
may decide to perform a kidney biopsy if the tests show signs of deterioration
of one or more of your kidney functions.
your doctor ordered this procedure may be:
To find the cause of abnormally high waste products in the blood
To decide whether a renal mass is benign or malignant
To find the cause of hematuria, defined as the presence of urine in the blood
To investigate the underlying cause of proteinuria, which means high levels of protein in the urine
To create a treatment plan for the kidney with the disease
2. Types of Kidney Biopsy
Usually, a kidney biopsy can be performed in the hospital as an outpatient procedure. Although it varies from hospital to hospital, this can be done with the help of CT or USG in the radiology department.
two main types of renal biopsy.
biopsy is the most commonly used procedure. The doctor sends a thin biopsy
needle through the skin to the kidney to remove a small sample of the mass from
In the open biopsy procedure, the doctor makes a small incision in the skin and takes small tissues from the areas of the diseased kidney.
percutaneous biopsies are performed by a physician and take approximately 1
wear the gown provided by the hospital just before the procedure. Your doctor
may then give you a sedative medication through the IV line in order to make
percutaneous biopsy procedures, you do not normally need to have any general
anesthesia, so you are awake during the entire procedure.
asked to take a position to lie on your stomach. Thus, access to your kidneys
for biopsy can be provided more easily. You are also provided with a pillow or
towel because you need to remain in this position and stay still for about half
In the next
step, your doctor will inject a local anesthetic agent at the site of the
biopsy will be taken. He then sends the special needle to be used for biopsy
from this region to your kidney. In the meantime, imaging methods
such as CT or USG can be used in order to reach the exact desired location.
Your doctor asks you to take a deep breath and hold it while he will take the sample tissue from your kidney. This process takes approximately 35 to 40 seconds. You may then experience discomfort while taking a biopsy and extracting the tissue.
two types of percutaneous biopsies:
Fine needle aspiration biopsy: With this method, your doctor uses a thin, small needle to extract tissue from your kidney. There is a syringe at the end of the needle.
Needle core biopsy: This method is usually preferred for obtaining larger tissue samples. During this procedure, your doctor will extract larger sample tissue from your kidney with a spring-loaded needle.
After the biopsy is completed, if there is bleeding in the biopsy area, the pressure is applied until bleeding stops. The bandage is then applied over the incision site.
on your health status and medical history, your doctor may recommend an open
biopsy for you.
method is generally recommended if any bleeding or clotting problem has already
occurred in your kidney, in your history. If you have a single kidney, an open
biopsy method is generally preferred.
If an open
biopsy is to be performed, you should undergo general anesthesia. When you are
unconscious, your doctor makes a small incision and takes the sample tissue
from your kidney. Some of these open biopsies may require incisions of about 6
An open biopsy can also be performed by laparoscopy. In such a case, your doctor can take a biopsy sample through a small and long tube with a small incision.
used a camera to view the inside of the abdomen. From a small incision, this
special camera is sent into the abdomen and the biopsy sample from the kidney
can be removed correctly with visualization.
3. After Renal Biopsy
After a renal biopsy procedure, you will need a period of time for recovery and observation. You can go home when your doctor determines that you can safely leave the hospital.
process may vary greatly depending on your health condition, your doctor’s practice,
and your reaction to the biopsy procedure.
Usually, after the biopsy, you will be taken to a room where your vital signs can be observed and you can rest.
recommended that you lie on the bed without moving in this process.
varies from hospital to hospital, on average this whole process takes between 6
and 8 hours.
time period, a nurse or doctor will regularly check important life-related
parameters, including your blood pressure and pulse.
urine tests are also performed to determine if there is any internal bleeding
or other problem.
If you feel
pain in the biopsy area, you may also be given medicine to relieve this pain.
vital signs such as blood pressure and pulse are stable, you will be allowed to
leave the hospital. This follow-up process, which is thought to allow you to
leave the hospital safely, takes a period between 12 hours and 24 hours after
the biopsy procedure.
normal to have light blood in your urine for up to 24 hours after the biopsy
procedure. However, if such a condition persists for more than 24 hours, you
should consult your doctor.
continue your daily diet after the biopsy procedure. Your doctor will probably
recommend bed rest from 12 to 24 hours. In this process, you should avoid strenuous
activities or heavy lifting for up to 2 weeks.
It is also
recommended that you avoid any activity that includes bouncing such as jogging,
aerobic exercises, for a period of 2 weeks. If you feel any pain in your biopsy
area that is bothering you, you can take painkillers to relieve your pain.
4. Possible Renal Biopsy Risks
A renal biopsy will provide your doctor with very accurate and clear information about any abnormality or disease in your kidney. In this way, you can get the most appropriate treatment for the problems you have.
One of the most important complications after the renal biopsy is possible infections. However, this is extremely rare. After the biopsy, you are strongly advised to pay attention to any symptoms that may indicate infection. Some of these symptoms can be listed as;
Light blood or clot in urine for more than 24 hours
Chills or fever
Pain in biopsy area which increases in intensity
Complaints such as redness, swelling or discharge in the biopsy area
A feeling of faint or weak
to the infection, kidney biopsy also has the potential to damage nearby organs
and tissues, as well as all other biopsy procedures.
5. What Should be Done to Prepare for Kidney Biopsy?
you do not need to make too much preparation for kidney biopsy.
As with all
other biopsy procedures, you should tell your doctor about the medications, over-the-counter
medications, and herbal supplement that you are taking.
It is very
important that you discuss with your medical team and your doctor about
stopping these drugs or reducing their dosage before the biopsy.
regularly use medications that affect the kidney biopsy procedure, your doctor
may provide special instructions.
may affect the renal biopsy process;
NSAIDs (aspirin, ibuprofen, etc.)
Herbal or dietary supplements
Any drug that may affect blood clotting
addition, if you are pregnant or think you are pregnant, be sure to share it
with your doctor.
also need to give a urine sample prior to kidney biopsy. In this way, it can be
understood whether there is any urinary tract infection.
A renal biopsy requires fasting from food and drink at least a period of 8 hours before your procedure.
If you have
been given a sedative medication to take at home before the procedure, you must
not come to the hospital using a vehicle.
6. Renal Biopsy Results
procedure, the sample taken from your kidney is sent to the laboratory for
pathologist, who is an expert in this field in the laboratory, examines the
tissue sample to determine if there are any problems.
sample taken from your kidney is stained with various dyes and then examined
under a microscope. The pathologist investigates whether there is any scar or
deposit in the tissue.
Any abnormal condition such as an existing infection or tumor can also be detected.
after about one week, the pathologist will send a detailed report about the
tissue he or she is examining to your doctor. If there is no deposit or defect
in your kidney, your kidney may be considered healthy.
However, if the results are different from normal tissue, a kidney biopsy is considered abnormal. There are several situations that can cause this. Although kidney cancer is the most important of these, other conditions can be listed as follows;
restrictions or weaknesses in the flow of blood to the kidneys
connective tissue diseases
rejection of a kidney transplant
complicated urinary tract infection
numerous other diseases that have a negative effect on kidney function
After this process, your doctor may find the result sufficient to decide the treatment or order additional tests to achieve a clearer result.
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