Kidney Biopsy, Here's What You Should Know

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Kidney Biopsy, Here's What You Should Know
Kidney Biopsy, Here's What You Should Know
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Kidney biopsy is a procedure to take a sample of kidney tissue. This procedure can be performed for various purposes, such as detecting kidney problems, checking the condition of the kidneys, and monitoring the effectiveness of treatment for kidney disease

Kidneys are a pair of organs that have an important function to filter and remove waste substances, minerals, fluids, and toxins from the body through urine (urine).

Kidney Biopsy, Here's What You Should Know - Alodokter

When there is a problem with the kidneys, various complications can arise, ranging from the accumulation of waste in the body to damage to the central nervous system. In order to find out the cause of kidney disorders as well as determine the right treatment, one of them can be done with a kidney biopsy.

Kidney biopsy is a procedure to take a sample of kidney tissue for later analysis under a microscope. Through this tissue sample, doctors can determine the condition of the patient's kidneys. In addition to diagnostic purposes, kidney biopsy can also be used to evaluate treatment for the kidney.

Kidney Biopsy Types

Kidney biopsy can be done by three methods, namely percutaneous biopsy, open biopsy, or laparoscopic biopsy. The method used will be adjusted to the patient's condition and the patient's own decision.

The following are kidney biopsy methods and their explanations:

Percutaneous biopsy

This method is the most frequently used method for sampling kidney tissue. A percutaneous biopsy is performed by inserting a needle through the surface of the skin over the kidney. In the process, an ultrasound or CT scan is used to help the doctor direct the needle to a specific area of ​​the kidney.

Open biopsy

This method is usually the choice for patients who fail to perform a percutaneous biopsy or who require more tissue samples. An open biopsy is performed by making an incision in the skin so that the kidney can be directly accessed for tissue collection.

Biopsies by laparoscopy

A laparoscopic biopsy is done by making a small incision in the skin near the kidney area. Through this incision, the doctor will insert a laparoscope, which is a small tube-shaped instrument with a camera.

This biopsy may be an option for patients who have a blood clotting disorder or have only one functioning kidney.

Indications of Kidney Biopsy

Kidney biopsy is generally used to diagnose nephrotic syndrome, acute nephritic syndrome, or acute kidney failure of unknown cause. However, a kidney biopsy can also be performed on a person who has the following conditions:

  • Experiencing hematuria or bloody urine
  • Experiencing albuminuria or proteinuria, which is a condition when it is known that there is excessive protein in the urine
  • Has a problem with kidney function, which causes a buildup of waste in the blood
  • Has had a kidney transplant which didn't work out well

Some of the purposes of performing a kidney biopsy are:

  • Diagnosing diseases or conditions involving the kidneys, and those that cannot be identified by blood or urine tests
  • Planning treatment for diseases or conditions involving the kidneys
  • Determining the stage or progression of kidney disease
  • Monitoring the effectiveness of treatment for kidney disease
  • Monitoring of follow-up conditions after a kidney transplant or finding out why the transplanted kidney is not working properly

Kidney Biopsy Alert

Kidney biopsy must be done as indicated or according to the doctor's considerations and advice. To undergo a kidney biopsy, the patient must provide complete information about his he alth condition so that the risk of complications can be reduced. The patient also needs to undergo several examinations before the biopsy is performed.

Kidney biopsy may be postponed or even canceled if the following conditions are found from the doctor's consideration or examination:

  • Immune system disorders, multiple sclerosis, or other conditions that can make bleeding difficult to control
  • severe hypertension, which cannot be controlled with antihypertensive drugs
  • Kidney infection
  • Skin infection in the biopsy area
  • Polycystic kidney disease (PKD)

In addition to the above conditions, doctors also do not recommend kidney biopsy in patients who have end-stage chronic kidney disease, have only one functioning kidney, have kidney deformities, or suffer from kidney swelling due to accumulation of urine (hydronephrosis).).

During the kidney biopsy procedure, the doctor may perform some additional procedures, such as blood transfusion or surgery to repair damaged blood vessels. However, this rarely happens.

Before Kidney Biopsy

Before undergoing a kidney biopsy, the doctor will ask the patient a number of questions regarding their complaints, past medical history, medications used, and history of allergies to anesthetics, latex, or other drugs.

If the patient is taking a blood thinner, such as aspirin, the doctor will ask the patient to stop taking the drug.

After that, the doctor will do a physical examination to make sure the patient is in good he alth. The doctor will also perform blood tests or urine tests to make sure the patient does not have an infection or other conditions that can increase the risk of complications.

Even though pregnancy is not a contraindication, patients who are pregnant still need to inform the doctor, so that the doctor can further consider whether the condition of the mother and fetus is safe to undergo a kidney biopsy.

For patients undergoing open biopsy or laparoscopic kidney biopsy, the doctor will ask the patient to fast for 8 hours before the procedure. In addition, if the patient feels afraid during the procedure, the doctor can give a sedative.

Kidney Biopsy Procedure

Each kidney biopsy method has different stages of the procedure. The full explanation is as follows:

Percutaneous biopsy procedure

In a percutaneous biopsy, kidney tissue is removed using a needle that is inserted through the skin closest to the kidney. To direct the needle, the doctor will use the help of ultrasound or CT scan.

The following are the steps performed by a kidney doctor in the percutaneous biopsy method:

  • The doctor will identify the area where the needle will be inserted with the help of an ultrasound or CT scan.
  • The doctor will clean the specified skin area, then give local anesthesia so that the patient does not feel pain when the needle is inserted.
  • The doctor will make a small incision on the surface of the skin for the needle to enter.
  • After the needle is inserted, the patient will be asked to take a deep breath so the doctor can take a tissue sample.
  • The doctor may insert the needle several times until the sample of kidney tissue required is sufficient.
  • Once a tissue sample has been obtained, the doctor will remove the needle and apply pressure to the area to stop the bleeding.
  • The doctor will put a bandage on the biopsy area.

Open biopsy procedure

An open biopsy is performed by making a large incision in the skin near the kidney. This procedure requires general anesthesia (general anesthesia), so the patient will fall asleep and feel no pain during the procedure.

After the anesthetic works, the doctor will perform an open biopsy with the following steps:

  • The doctor will make an incision to directly access the kidney.
  • Once the kidney is visible, the doctor will determine the part of the kidney where the tissue sample will be taken.
  • The doctor will take the sample, then put it in a small tube.
  • After the sample is taken, the doctor will close the incision with stitches.

Laparoscopic biopsy procedure

A laparoscopic biopsy is done using a special instrument in the form of a camera tube called a laparoscope. The doctor will make a small incision in the skin to provide access for the device. Like an open biopsy, a laparoscopic biopsy also requires general anesthesia (general anesthesia).

The following are the steps of a laparoscopic biopsy:

  • The doctor will make a small incision in the abdomen or back area to insert the laparoscope.
  • After the laparoscope is in, the doctor will deliver gas so that the abdominal cavity bulges, so that the kidneys are seen more clearly through the monitor.
  • The doctor will insert a cutting tool to take a tissue sample.
  • After a sample of kidney tissue is taken, the doctor will remove the laparoscope and cutting tools, then expel the gas.
  • After the biopsy equipment and gas are removed, the doctor will close the incision with stitches.

After Kidney Biopsy

After undergoing a kidney biopsy procedure, the patient will be taken to the treatment room to rest and reduce the anesthetic effect, approximately for 4-6 hours. The doctor will monitor the patient's blood pressure, pulse, temperature, and breathing.

Generally, patients can be allowed to go home on the same day. However, the patient must first undergo a urine test and a blood test to confirm whether there is bleeding or other complications.

After the biopsy, the patient's urine will usually contain a little blood. This is normal. However, if the bleeding is too much, the patient needs to immediately notify the doctor so that he can be treated as soon as possible.

Even though they are allowed to go home, the patient still needs to rest for 1-2 days. Patients are also advised not to do strenuous activities, such as lifting heavy weights, for at least 2 weeks after surgery.

Risk of Kidney Biopsy

Kidney biopsy is generally safe to do. However, that does not mean this procedure is not without risk. The following are some of the risks that can occur after undergoing a kidney biopsy:

  • Bleeding, redness, and swelling in the biopsy area
  • Infection in the biopsy area
  • bloody pee
  • Pain in the biopsy area
  • Arteriovenous fistula, which is the formation of an abnormal connection between two blood vessels that can occur due to injury from the biopsy needle
  • Hematoma

Call your doctor immediately if you experience any of the following symptoms after a kidney biopsy:

  • Unable to urinate, but keeps feeling like urinating
  • Feeling pain or burning when urinating
  • Urine is dark red or brown
  • Bandage that covers the biopsy area is wet with blood or pus
  • Fever
  • Feeling weak

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