How to Prepare For Kidney Biopsy?
The doctor explains what the procedure will look like and how you need to prepare for it properly. You need to know the advantages and disadvantages of having a kidney biopsy.
Medications
Your doctor must be well aware of the type of medications you’re currently taking, if any. It’s best to disclose all the drugs and supplements you’re taking, including over-the-counter medications, vitamins and herbal supplements. Before your kidney biopsy, you’ll need to abandon medicines and supplements that can increase the risk of bleeding. These include:
- Blood-thinning medications, such as warfarin (Coumadin, Jantoven), rivaroxaban (Xarelto), dabigatran (Pradaxa) or enoxaparin (Lovenox)
- Drugs that keep blood platelets from excessively sticking together, such as clopidogrel (Plavix)
- Aspirin
- Ibuprofen (Advil, Motrin IB, others) and other nonsteroidal anti-inflammatory drugs (NSAIDs)
- Certain dietary supplements, such as omega-3 fatty acids
Your doctor or nurse will let you know when to stop taking these medications and supplements and for how long. Often, these medications are stopped seven days before the procedure and then started again seven days after the procedure.
Blood and urine samples
Before your biopsy, you’ll have blood drawn and provide a urine sample to ensure you don’t have an infection or another condition that would make the biopsy risky.
Diet
You may be asked not to drink or eat for eight hours before the kidney biopsy.
What you can expect
You’ll have a kidney biopsy at a hospital or outpatient center. An IV will be placed before the procedure starts. Sedatives may be given through the IV.
During the procedure
During the biopsy, you’ll be awake and lie on your abdomen or your side, depending on which position allows best access to your kidney. Most people lie on their backs for a biopsy of a transplanted kidney.
A percutaneous biopsy includes these steps:
- With an ultrasound probe, your doctor identifies exactly where to insert the needle. In some cases, a CT scan may be used instead of ultrasound.
- Your doctor marks your skin, cleans the area and applies a numbing medication (local anesthetic).
- Your doctor makes a small incision where the needle will go in and uses the ultrasound device to guide the needle into your kidney.
- You may be asked to hold your breath as your doctor collects a sample using a spring-loaded instrument. You may feel a “pop” or pressure and hear a sharp clicking noise.
- Your doctor may need to insert the needle several times — often through the same incision — to get enough tissue.
- Your doctor removes the needle and places a small bandage on the incision.
Other kidney biopsy procedures
Percutaneous kidney biopsy isn’t an option for some people. However, if you have a history of bleeding problems, blood-clotting disorder or only one kidney, your doctor may consider a laparoscopic biopsy.
In this procedure, your doctor makes a small incision and inserts a thin, lighted tube with a video camera at its tip (laparoscope). This tool allows the doctor to view your kidney on a video screen and remove tissue samples.
After the procedure
After the biopsy, you can expect to:
- Spend time in a recovery room where your blood pressure, pulse and breathing will be monitored.
- Have urinalysis and complete blood count tests done to check for bleeding and other complications.
- Rest quietly for around four to six hours.
- Receive written instructions about your recovery.
- Feel some soreness or pain at the biopsy site for a few hours. You’ll be given medications to relieve pain.
Most people can leave the hospital the same day, about 12 to 24 hours after the procedure. Once home, your doctor will probably recommend that you rest for another day or two. Your health care team will let you know about any activity restrictions, such as avoiding heavy lifting and strenuous exercise.
Your kidney tissue goes to a lab to be examined by a doctor specialising in diagnosing disease (pathologist). The pathologist uses microscopes and dyes to look for unusual deposits, scarring, infection or other abnormalities in the kidney tissue.
Call your doctor if you experience:
- Significant bright red blood or clots in your urine more than 24 hours after the biopsy
- Changes in urination, such as an inability to pass urine, an urgent or frequent need to urinate, or a burning sensation when urinating
- Worsening pain at the biopsy site
- Fever over 100.4 F (38 C)
- Faintness or weakness
Results
It may take up to a week before your doctor has your biopsy report from the pathology lab. However, a full or partial report may be available in less than 24 hours in urgent situations.
Your doctor will usually discuss the results with you at a follow-up visit. The results may further explain what’s causing your kidney problem, or they may be used to plan or change your treatment.
