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Why Have A Kidney Biopsy

Results Of A Renal Biopsy

Kidney 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

How To Prepare For The Test

Tell your health care provider:

  • About medicines you are taking, including vitamins and supplements, herbal remedies, and over-the-counter medicines
  • If you have any allergies
  • If you have bleeding problems or if you take blood-thinning medicines such as warfarin , clopidogrel , dipyridamole , fondaparinux , apixaban , dabigatran , or aspirin
  • If you are or think you might be pregnant

Are There Any Risks To Having A Biopsy

The vast majority of kidney biopsies happen without any problems. There are some problems which may occur:

  • Blood in your urine: Usually this will stop by itself and needs not further action. You may have to stay in hospital a little longer until the doctors and nurses are happy the bleeding has stopped.
  • Blood transfusion: If the bleeding is heavier or continues for a longer period, you may need a blood transfusion.
  • Operation to stop the bleeding: If the bleeding is particularly heavy or is not stopping you may need to go the X-ray department . A wire can be inserted into the top of your leg and threaded up to your kidney so that a doctor can stop the bleeding directly .
  • Removal of the kidney or damage to other organs : If the bleeding from the kidney cannot be stopped or another organ is damaged accidentally, then you may need to have an operation to repair the damage. This may mean removing the bleeding kidney altogether.
  • Inadequate sample: In some cases the sample taken is not enough to make a diagnosis. Your kidney doctor will talk to you about repeating the biopsy if this is the case.

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What Happens During A Kidney Biopsy Procedure

A kidney biopsy may be done on an outpatient basis or in a hospital. It maybe done in a procedure room, in a hospital bed, or in the radiologydepartment. Procedures may vary depending on your condition and yourhealthcare providerâs practices.

Generally, a kidney needle biopsy follows this process:

  • You will remove your clothing and put on a hospital gown.

  • An intravenous line may be started in your arm or hand.

  • You will lie on your stomach so that the healthcare provider can easily reach the kidney. A pillow may be used to hold you in the right position. If you have a transplanted kidney, you will lie on your back.

  • The skin over the biopsy site will be cleaned with an antiseptic solution.

  • You will feel a needle stick when the local anesthetic is injected. This may cause a brief stinging sensation.

  • You will need to lie still during the procedure.

  • Ultrasound or X-ray may be used to guide the needle into the kidney.

  • You will be asked to breathe in and hold your breath while the healthcare provider inserts the biopsy needle into the kidney. This prevents movement of the diaphragm, which may interfere with the placement of the biopsy needle.

  • You may feel discomfort or pressure when the healthcare provider takes the sample.

  • There may be more than one puncture if the healthcare provider needs more than one tissue sample. If so, the same puncture process will be repeated.

  • When the needle is withdrawn, firm pressure will be applied to the biopsy site to stop bleeding.

  • When Will I Find Out The Results

    The Know

    The results of the biopsy will not be ready immediately and will usually be discussed at your next clinic appointment. If you don not have a clinic appointment then let the nurses or kidney doctor know before you go home.

    Occasionally a biopsy is urgent or shows a result that requires treatment to start before your next appointment. If this is the case, the kidney doctors will contact you directly. You should make sure they have a current phone number for you before you go home.

    If there are problems after the biopsy, they usually occur whilst you are still in hospital, however when you go home it is important to follow the contact advice that you will be given if:

    • You have blood in your urine
    • You are unable to pass urine
    • You are having fevers
    • You feel light-headed or dizzy
    • Any discomfort is worsening rather than getting better

    If you feel particularly unwell you should call 999 or go to your nearest emergency department.

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    What Does The Biopsy Involve

    Once your child is under general anaesthetic or has had Entonox®, they will lay on their left side if their own kidney is being biopsied. When a child has two kidneys, we usually take a biopsy from the one on the right hand side. If the biopsy is on a transplanted kidney, your child will lie on their back, as this makes it easier to reach the transplanted kidney. The exact position of the kidney is confirmed using an ultrasound scan, which also identifies the best place to take the biopsy. This is usually at the lower and outer part of the kidney.

    Local anaesthetic is injected under the skin at the biopsy site and along the path between the skin and the kidney. The only cut that is made is a tiny nick in the skin to allow the biopsy needle to enter more easily. This nick is 2mm to 3mm long and is so small that it does not need a stitch afterwards.

    The biopsy needle has a hollow centre, and when it is removed, it brings a very fine core of kidney with it. This is about the size of a grain of rice and is approximately 1cm to 2cm long. This tiny piece of kidney will contain between 10 and 50 glomeruli, which are the little filtering units within the kidney. This will not affect kidney function as each kidney contains about a million glomeruli. Usually two or three samples are taken so that enough tissue is available for testing in our laboratories.

    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.

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    How Is An Endometrial Biopsy Done

    • The endometrium is the lining of the womb. It cannot be accessed through the skin, from the outside. It has to be looked at or biopsied from the inside.
    • A specialist will do a camera test to look inside your womb . Using a small needle they can then take a sample of the lining of the womb, or they can suck a tiny bit of the lining off using a syringe.
    • It is not normally painful and you can be awake for the procedure.

    When Will I Get The Results

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    The biopsy is processed in three different ways. First of all, we look at it under a microscope. This may give us some information within a day or two. We then do special stains on the sample, which takes a bit longer, and electron microscopy, which takes longer again. We may have some results available while you are still in hospital, but would need to allow six weeks to be sure that the others are back. You need to make sure that when you leave the hospital, you have an appointment for six weeks or sooner if you are asked to do so.

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    How Do I Prepare For A Cystoscopy Or Ureteroscopy

    Your urologist will ask about your medical history to determine whether you need a cystoscopy or ureteroscopy. You may need to give a urine sample to test for a UTI. If you have a UTI, you may need to take antibiotics before either procedure.

    Your urologist will also ask about any medicines you are taking, ask if you have any allergies, talk about anesthesia, give instructions for what to do before the procedure, and discuss what to expect afterward. In some cases, you wont need special preparations for a cystoscopy. In other cases, your instructions may include

    • when to stop certain medicines, such as blood thinners
    • when to stop eating and drinking or, conversely, when to drink plenty of liquids
    • when to empty your bladder before the procedure
    • whether to arrange for a ride home after the procedure

    How Do I Prepare For A Kidney Biopsy

    Some medications can decrease blood clotting and increase the risk of bleeding during the procedure. You should stop taking these medications, including aspirin, warfarin, apixaban, ibuprofen, and other blood thinners and anti-inflammatory drugs at least one week before a kidney biopsy. Your doctor will ask about any other medicines or supplements you take and recommend any needed changes to your medication regimen.

    Your doctor will take urine and blood samples before the biopsy to make sure you do not have any infections or other conditions that could cause complications. In most cases, doctors tell people not to drink or eat anything after midnight prior to the biopsy.

    Itâs important to take other medication as usual on the day of biopsy. Blood pressure medication should be taken to avoid high blood pressure at the time of biopsy, and medicine may be taken with sips of water.

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    Why Do Health Care Professionals Perform Ureteroscopy

    A urologist performs a ureteroscopy to find the cause of urine blockage in a ureter or to evaluate other problems inside the ureters or kidneys. During a ureteroscopy, a urologist can see

    • a stone in a ureter or kidney
    • problematic tissue, tumors, or cancer in a ureter or in the lining of a kidney

    During a ureteroscopy, a urologist can treat problems such as urine blockage in a ureter. The urologist can also

    • remove a stone from a ureter or kidney
    • remove or treat abnormal tissue and tumors
    • take a sample of ureter or kidney tissue for a biopsy

    Why Kidney Biopsy Is Needed

    Tysne: Kidney Biopsy

    kidney biopsy

    . Also to know is, what is the purpose of a kidney biopsy?

    A renal biopsy is a procedure used to extract kidney tissue for laboratory analysis. The word renal describes the kidneys, so a renal biopsy is also called a kidney biopsy. The test helps your doctor identify the type of kidney disease you have, how severe it is, and the best treatment for it.

    One may also ask, what are they looking for in a kidney biopsy? A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. A health care provider will perform a kidney biopsy to evaluate any of the following conditions: hematuriablood in the urine, which can be a sign of kidney disease or other urinary problems.

    Correspondingly, how serious is a kidney biopsy?

    The most common complication of a kidney biopsy is blood in the urine . The bleeding usually stops within a few days. Bleeding that’s serious enough to require a blood transfusion affects a very small percentage of people who have a kidney biopsy. Rarely, surgery is needed to control bleeding.

    How long does it take to recover from a kidney biopsy?

    Your RecoveryAfter a needle kidney biopsy, you will be told to lie down on your back for several hours. After this, you should avoid strenuous activity for the next 2 to 3 days. It’s normal to feel some soreness in the area of the biopsy for 2 to 3 days.

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    Biopsy Of Renal Transplant Allograft

    A survey by the United Network for Organ Sharing showed great disparities in practice across US transplant centers regarding the timing and performance of surveillance kidney transplant biopsies for diagnosing subclinical graft rejection. The most common timeframe for surveillance biopsies was 3 and 12 months post-transplant. The 1- and 3-year graft survival was similar among centers performing biopsies compared with those not performing biopsies. The survey results showed the controversies around surveillance biopsies and the management of subclinical rejection.

    Rush et al from the Manitoba Adult Renal Transplant Program were the first to report the finding of subclinical rejection within the first 3 months after kidney transplantation. Subclinical rejection can be broadly defined as lymphocytic infiltration of a renal allograft with normal function.

    Rush et al further classified subclinical rejection as an increase in serum creatinine by more than 10% 2 weeks before the protocol biopsy and a histologic Banff score of ai2at2 or greater. The controversy regarding this topic is whether detecting subclinical rejection from a specific biopsy protocol can guide early successful treatment of renal allograft pathology, ultimately improving long-term graft function.

    In a high-risk transplant , the allograft interval biopsy schedule remains the mainstay for surveillance in this particular category of patients in whom the graft might be compromised by silent immunologic processes.

    What Happens After The Kidney Biopsy

    Your recovery will vary depending on the type of procedure done and yourhealthcare provider’s practices. You may be taken to the recovery room andwatched closely as the anesthesia wears off. Once your blood pressure,pulse, and breathing are stable and you are alert, you may be taken to ahospital room or discharged to your home.

    You will be asked to lie on your back for several hours. A nurse will checkyour urine for signs of bleeding. You may have blood tests to check forinternal bleeding. You may be discharged later the same day or the nextday. If you had a sedative or anesthetic, plan to have someone drive youhome.

    The biopsy site may be tender or sore for several days after the biopsy.Take a pain reliever for soreness as advised by your healthcare team. Youmay need to avoid aspirin or certain other pain medicines that may raisethe chance of bleeding. Be sure to take only recommended medicines.

    Tell your healthcare team to report any of the following:

    • Blood in your urine after the first 24 hours

    • Inability to urinate

    • Redness, swelling, or bleeding or other drainage from the biopsy site

    • Increased pain around the biopsy site or elsewhere

    • Feeling faint

    Your healthcare provider may give you other instructions after theprocedure, depending on your situation.

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    Before you agree to the test or the procedure make sure you know:

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    How Is The Sample Obtained In A Transplant Kidney Biopsy

    There are two ways to obtain the sample during a transplant kidney biopsy. A needle can be used that will go through the skin and into the kidney. The needle then is used to collect the sample. An ultrasound image is used to help guide the needle to the correct spot. This process is called a percutaneous biopsy. The second method would be to take a sample during surgery, this is much less common. Ultrasound guided transplant kidney biopsies are most often done under local anesthesia.

    What Happens After The Biopsy

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    After the tissue is collected and preserved, it’s delivered to a pathologist. Pathologists are doctors who specialize in diagnosing conditions based on tissue samples and other tests.

    A pathologist examines the biopsy tissue under a microscope. By noting the tissue cells’ type, shape, and internal activity, in most cases a pathologist can diagnose the problem.

    The time it takes to get results from a biopsy can vary. During a surgery, a pathologist may read a biopsy and report back to a surgeon in a few minutes. Final, highly accurate conclusions on biopsies often take a week or longer. You will probably follow up with your regular doctor to discuss the biopsy results.

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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.


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