How Painful Is A Kidney Biopsy
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How Do I Get Ready For A Kidney Biopsy
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Your healthcare provider will tell you about the procedure and can ask questions.
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You will be asked to sign a consent form that gives your permission to do the kidney biopsy. Read the form carefully and ask questions if something is not clear.
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Your healthcare provider may do a physical exam to be sure you are in otherwise good health. You may have blood tests or other diagnostic tests.
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Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, and anesthesia.
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Tell your healthcare provider of all medicines and herbal supplements that you are taking.
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Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant medicines, aspirin, or other medicines that affect blood clotting. You may need to stop these medicines before the procedure.
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If you are pregnant or think you might be, tell your healthcare provider before the procedure.
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You may be asked to fast before the biopsy, generally after midnight or at least 6 hours before getting anesthetic or sedatives. Your healthcare team will give you specific instructions.
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You may get a sedative before the procedure to help you relax. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home.
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Based on your medical condition, your healthcare team may request other specific preparation.
What Are Some Of The Risks Of A Transplant Kidney Biopsy
While the risks of a biopsy are small, complications could occur. Bleeding may occur. About a third of patients have some light red color in the urine for a day or so of little consequence. About 1-3% of patients have bleeding with clots that required a bladder irrigation with a catheter to clear them. If the bleeding is severe enough, a transfusion may be needed. However, this is a very rare occurrence in less than 1% of patients. Very rarely a urine infection may occur, especially in patients with a history of frequent urine infections. Other problems to watch for include fever, pain at the site of the biopsy, dizziness, or not being able to urinate.
Last reviewed by a Cleveland Clinic medical professional on 11/05/2019.
References
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How Will I Recover From A Kidney Biopsy
Youâll lie flat for several hours after the procedure while your doctor and nurses monitor you. After a native kidney biopsy, most patients spend one night in the hospital.
After a transplant kidney biopsy, most people go home the same day. Youâll need someone to give you a ride home, because you may feel drowsy from the medications.
You should expect to remain quiet and rest for about a day after the procedure.
Fluid Retention Is A Main Symptom
Fluid retention occurs when fluid leaks out of blood vessels into the body tissues. This causes swelling and puffiness of the affected tissues. The swelling is usually painless but the swollen tissues may feel tight. With children, the face is often affected first and the face becomes puffy. With adults, the ankles often become swollen at first . As fluid retention becomes worse, the calves and then the thighs may become swollen.
In severe cases, the fluid retention can become extensive. Fluid may accumulate in the lower back, the arms, in the tummy cavity or in the chest between the lungs and the chest wall . Ascites can cause tummy pain and discomfort due to distension. Pleural effusions may cause chest pain and breathlessness.
The main reason why fluid leaks out from the blood vessels and into the body’s tissues with nephrotic syndrome is because of a low level of protein in the blood. As protein is lost from the body in the urine, the body makes more protein in the liver which passes into the bloodstream. However, in time the amount made by the liver cannot keep up with the amount lost by the leaky kidneys and so the blood level of protein goes down. If the blood level of protein is low then fluid tends to leak out of the blood vessels into the body tissues.
Note: nephrotic syndrome is just one cause of fluid retention. There are other causes of fluid retention. For example, heart failure is the most common cause of fluid retention, especially in older people.
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What Can A Person Expect After A Kidney Biopsy
After a kidney biopsy, a person can expect to
- lie on his or her back in the clinic or hospital for a few hours. During this time, the staff will monitor the persons blood pressure, pulse, urine, and blood test results.
- go home the same day, in most cases; however, a person will need to rest at home for 12 to 24 hours after the biopsy. Sometimes a person may need to stay overnight at the hospital.
- have some pain or soreness near the point where the needle went through the skin.
- receive written instructions for ensuring a healthy recovery from the procedure. Most people need to wait 2 weeks before resuming strenuous activities, such as heavy lifting or participating in contact sports.
A health care provider most often receives the complete biopsy results from the pathologist in about a week. In urgent cases, a person may receive a preliminary report within 24 hours. The health care provider will review the results with the person during a follow-up visit.
Should I Get A Biopsy
A question that we hear all the time. There is a theoretical risk of bleeding or spreading the cancer with a biopsy, but this not why they are not widely used.
Unlike prostate, breast, or colon biopsies it turns out that biopsies of small kidney tumors are not as accurate as we would like.
As many as 20% of the biopsies are “false negatives”- in other words the biopsy says there is no cancer when indeed there is a cancer.
We still use them sometimes but it has to be in the right patient. Recent innovations in how we do the biopsies has allowed us to get more information than ever before. It remains, however, that a biopsy should only be obtained after a discussion with an expert on this disease!
Treatment options for patients with a small kidney tumor including active surveillance, ablation, partial nephrectomy, and total nephrectomy. In the vast majority of patients treatment of a small kidney tumor should result in saving the kidney. A quick decision to remove the kidney may not be the best treatment. Experience is critical in being able to save the kidney. In our section regarding treatment one can find details regarding these options.
At Johns Hopkins our surgeons are experts on all approaches and will help tailor the treatment to the patient. One size does NOT fit all.
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Biopsy For Kidney Cancer Communicating Changes In Practice
One question that is routinely posted in our kidney cancer patient communities is: should I have a biopsy of my kidney tumor? The resounding chorus from others is almost always an emphatic: NO! its too dangerous youll spread the cancer.
For more than two decades, the use of biopsy in managing renal cell carcinoma has been shifting dramatically. Advances in cytological techniques as well as increases in the number of unnecessary surgeries have expanded the role of renal mass biopsy. The myth that renal mass biopsy is dangerous has also largely been dispelled by multiple studies.
Despite the fact that biopsy rates are increasing, that the procedure is known to be safe, and that it can result in a reduction in unnecessary surgeries, the shared view in patient communities remains resoundingly negative.;
Why do we think that biopsy is so dangerous?
In short? Because we were told that by doctors. If you or a loved one was diagnosed with kidney cancer in the last few decades, you might have been told that renal biopsies are never done and/or are not safe.
The reality is that biopsy;is;done in kidney cancer its just not;always;done. If a patient has a large tumor, imaging is generally sufficient to make a recommendation for surgery. It is not that it is dangerous to do a biopsy of the kidney, rather, it is just not necessary and there is no reason to put a patient through an additional invasive procedure.
What is tumor seeding?;
Bottom line:;
Risks Of A Renal Biopsy
A renal biopsy can provide valuable information that allows your doctor to diagnose kidney abnormalities and decide on appropriate treatments.
Developing an infection after the procedure is a serious risk. However, this rarely occurs. Always be on the lookout for symptoms that could indicate an infection after your renal biopsy. Contact your doctor if you:
- have bright red blood or blood clots in your urine for longer than 24 hours after your biopsy
- cant urinate
- have chills or a fever
- experience pain at the biopsy site that increases in intensity
- have redness, swelling, bleeding, or any other discharge from the biopsy site
- feel faint or weak
In addition to infection, a renal biopsy like any invasive procedure carries the risk of potential internal damage to the targeted organ or nearby areas.
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How Do I Prepare For The Kidney Biopsy
Please read this information leaflet. Share the information it contains with your partner and family so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this examination.
Most kidney biopsies are undertaken as a day case procedure. You will need to have some blood tests done beforehand to ensure it is safe to go ahead with the biopsy. These can be done at your doctors surgery, or you may need to attend the hospital. You will need a further blood test on the day of the biopsy.
If you take any blood thinning medicines, these must be stopped before the procedure and your kidney doctor will discuss this with you. On the day of the biopsy take all other medications as normal. It is essential the doctor has a full list of all your medicines, including any not prescribed. If you have not received any advice you should contact the renal department on 675050.
Bring any medication that you take regularly. It is important that your blood pressure is well controlled to be able to go ahead with the biopsy. If your blood pressure is too high on the day the biopsy is planned, the biopsy will be postponed. Some biopsies are done as an inpatient.
Do not drive on the day of the biopsy.
What Happens During A Kidney Biopsy
During a kidney biopsy, a doctor collects a sample of tissue from your kidney. Most biopsies are done through your back, although people with a transplanted kidney have the biopsy through their lower abdomen .
Your doctor will use one of these methods to take the sample:
- Percutaneous biopsy: In this more common type of kidney biopsy, a doctor numbs the skin located over the kidney and inserts a needle to take a small tissue sample from the kidney. Your doctor may use ultrasound imaging to guide the needle to the best location in the kidney.
- Open biopsy: In an open biopsy, a doctor makes an incision , removes tissue from the kidney, and closes the incision with stitches. Your doctor will give you anesthesia so you do not feel pain during the procedure. This type of biopsy is rare except at the time of kidney transplant.
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What Problems Can A Transplant Kidney Biopsy Show
The procedure can verify if the donor kidney is working well. Examples of abnormalities detected by the biopsy include rejection-both from antibodies or cells. Rejections can be rapid and aggressive or slow and subtle. Over time; damage to the kidney from the following may occur:
- Poor blood flow or scarring
- Viral or bacterial infections
- Evidence of kidney injury from certain drugs
- Evidence that a prior kidney disease has returned
- Evidence that a new kidney disease has begun
- Occasionally, kidney tumors or tumors from other sites in the body
Very often biopsy findings lead to changes or adjustments in treatment by your transplant doctor.
Results Of A Renal Biopsy
The tissue sample that was retrieved during your renal biopsy is sent to a laboratory for examination. A pathologist, a doctor who specializes in disease diagnosis, examines the tissue.
Your sample is analyzed under microscopes and with reactive dyes. The pathologist identifies and assesses any deposits or scars that appear. Infections and other abnormal conditions will also be detected.
The pathologist will compile the results and make a report to your doctor. Results are usually ready in about a week.
If the kidney tissue shows a normal structure that is free of deposits and other defects, the results are considered normal.
The results of a renal biopsy are considered abnormal if there are changes in the kidney tissue. There are numerous causes for this result. Sometimes, diseases that begin in other parts of your body can cause damage to the kidneys.
If results are abnormal, it could indicate:
- restrictions or weaknesses in the flow of blood to the kidneys
- connective tissue diseases
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What Is A Transplant Kidney Biopsy
While a kidney biopsy is a procedure where small samples of the kidney are removed in order to be examined by a pathologist under a microscope. A transplant kidney biopsy is done either as a screening test or to see what is happening with a kidney that is not working properly. It provides more information than can be obtained from a noninvasive procedure . Biopsy is considered the best option to diagnose problems with transplanted kidneys.
What Are The Complications Of A Kidney Biopsy
The risks of a kidney biopsy are small, but complications can occur. Some people experience bleeding after the procedure. Severe bleeding might require further treatment.
Other complications of a kidney biopsy may include:
- Dizziness.
- Pain at the biopsy site.
- Urine infection.
Contact your doctor if you experience complications of a kidney biopsy.
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Kidney Biopsy Tests: Procedures Risks & Results
- Kidney Care
A biopsy is a diagnostic test in which a doctor extracts a small piece of tissue from a specific body area to test for the presence or extent of a disease. When such a tissue is extracted from kidney, it is called kidney or renal biopsy. This test helps your doctor in identifying the type of;kidney disease;you may have, its severity, and defining a suitable treatment plan for it. Heres all you need to know about the renal biopsy.
After A Kidney Biopsy
You will need to lie on a bed and be observed for several hours to check that you have no bleeding. So, you may wish to bring in a book or a music player for this time. If you come into hospital for the test, you may need to stay in overnight. However, if the sample was done early in the morning, you may be able to go home later in the day. You may have some discomfort which is usually eased by painkillers. The result of the biopsy may take a week or so to come back.
Your doctor may advise you not to take part in contact sports such as rugby for a certain length of time after the procedure. This is to make sure the kidney has a chance to heal properly.
You should seek medical advice if:
- Your urine appears blood-stained.
- You develop tummy pain.
- The biopsy site becomes red or angry looking.
- You develop a high temperature .
- The biopsy site is still painful three days later and painkillers do not help.
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Types Of Renal Biopsy
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Percutaneous Biopsy :;It is a process in which a thin needle is inserted through the skin by your doctor. An ultrasound or computerized tomography scan guides the doctor to the exact location from where the kidney tissue needs to be extracted. It is the most frequently used technique.
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Open Biopsy :;This procedure is used when a larger kidney tissue is required. The patient is given anesthesia post which the doctor makes a small surgical incision in the skin near the kidneys. He then locates a suitable area in the kidney and removes a piece of kidney tissue and stitches the incision with sutures.
What Can I Expect After A Transplant Kidney Biopsy
During a standard biopsy, you will be observed for 1-2 hours in the recovery area to ensure you are well, can drink fluids, and pass urine comfortably. When released from the biopsy area, you should go directly home and stay indoors overnight. The next day you can walk or drive a car as needed. It will be important to avoid strenuous activity or heavy lifting for up to another two days after the procedure. If an open biopsy is required, you will receive further instructions.
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What Preparation Is Needed Before A Kidney Biopsy
You will usually have a blood test done shortly before the sample is taken. This checks how well your blood will clot – to make sure that you are not likely to bleed following the biopsy. You may be advised not to take any medicines that affect blood clotting, such as aspirin and warfarin, for one week before the biopsy.
You will need to sign a consent form at some point before the procedure to say that you understand what it involves and the risks and agree to allow the doctor to perform the procedure.