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What is it for?

A medical kidney biopsy is a procedure that is needed to assess your kidneys when there is a suspected problem. The biopsy can help to diagnose an underlying kidney disease, assess the progression of kidney disease and provide information for transplantation needs.

Why is it done?

A biopsy is needed to optimize your medical care and determine the best treatment options for you. It helps provide more specific information than blood or urine tests can.


What are the risks?

As with any biopsy, there is a small risk of bleeding at the site and a small risk of infection. With most biopsies these risks are very small, but with a medical kidney biopsy, the biopsy site is right next to small blood vessels. Still, bleeding complications are rare, but due to the location of the biopsy, we take extra precaution and admit you at the hospital overnight for observation to make sure your site heals properly.

Reasons to avoid this procedure?

If you have any abnormal bleeding conditions, or take blood thinning medication, we will need to be aware of them before the procedure so they can be addressed. Also if your blood pressure is not controlled or excessively high the test should be postponed as this could lead to increased bleeding.

How do you prepare?

You will need to be fasting for 8 hours before the procedure. In general, we recommend no eating or drinking after midnight the day before the procedure. You should continue to take your prescribed medications, especially your blood pressure medications, with a small sip of water on the day of your procedure, unless you have been instructed not to. If you take blood thinners you need to discontinue these medications before the procedure. You should avoid Aspirin, Motrin, Advil, Coumadin, Plavix, Xarelto, Eliquis and any supplements such as Fish oil and Ginko-Biloba, as these drugs can cause increased bleeding risk.

Please leave all valuables such as jewelry, credit cards and money at home on the day of the procedure. Family members may wish to bring a magazine or book to read during the extended wait time.

Once you arrive at the Admissions Unit, a nurse will prepare you for the procedure. This preparation will include changing into a gown, obtaining your vital signs, starting an IV in your arm and drawing blood for lab analysis.  Your IV will be used to give medications to help you relax (moderate sedation) and to avoid/counteract any potential additional side effects (nausea, infection, etc).

How is the procedure performed?

The procedure is performed in the Interventional Suite in the radiology department at the hospital. An entire team will be taking care of you during the procedure including a radiology nurse, a radiology technologist, pathology technician and the physician. In the procedure room, the nurse will help you lay on an exam table, on your stomach, as this is the best way to access the kidneys. You will be connected to a heart, blood pressure and oxygen monitor.  Some pre-procedure scans will be done (via ultrasound or CT) to localize the kidney for biopsy.  The procedure area will then be sterilely prepped and covered with a sterile drape.  Medication will be given through your IV, called moderate or “twilight” sedation that will keep you comfortable and pain free. Local anesthetic medication is also injected into the skin at the site of the procedure to numb the area.  Your oxygen saturation, blood pressure and pulse are monitored closely during and after the procedure.

Using ultrasound or CT guidance we will be able to introduce the biopsy needle precisely into the kidney. The imaging studies not only aid us for accuracy, but also helps us avoid important structures, like blood vessels and other organs. You may be asked to help during the biopsy by holding your breath when the doctor instructs you to. This helps to gain better visualization of the kidney. The biopsy itself only takes a few minutes as the access needle is passed quickly in and tissue sample(s) are taken through this needle.  The pathology technician will verify the specimen is adequate before the needle is removed. A small bandage will be applied to the biopsy site, stitches are not needed.  Post-biopsy images will be obtained to check for any possible bleeding.

The procedure may take from 10 to 30 minutes. Most of the procedure time is dedicated to getting the biopsy needle safely and accurately to the precise location in the kidney.

What you can expect after the procedure?

After the procedure you temporarily will go to the post surgical area at El Camino Hospital (unit 2B) while a room on the hospital floor is prepared for you.  You will be able to eat and drink after the procedure and your family members or friends can also sit with you soon after the procedure.  Once the hospital room is ready, you will be transferred there where you will stay overnight for close monitoring of your vital signs and procedure site for any signs of bleeding.  You will be assigned a nurse who will check on you periodically through the night and will respectively enforce strict bed rest to ensure you heal properly.  The next morning a blood test will be drawn to check your blood counts and compare them to the day before.  They should be relatively close to ensure there is no bleeding.  We want to be sure you do not have any problems before you go home.  If everything looks normal you will be discharged home likely before noon.

How long does it take to recover?

Most patients should be able to return to their normal activities once they go home.  However, avoid heavy lifting for 1 week after the procedure to minimize the chance of bleeding.  You should contact your referring physician to determine when to resume any anticoagulation medication such as Aspirin, Plavix, Coumadin, Xarelto or Eliquis.

What should I watch for?

It is normal to feel mild soreness at the procedure site and a small amount of blood in your urine for the first 48 hours. Any pain should be easily controlled with an ice pack or Tylenol, and should subside in 2-3 days. If you develop fever, bleeding at the site, bright red blood in your urine greater than 1 week, dizziness, low back pain, severe pain or if the pain is getting worse you should call us at 650-404-8445 and seek immediate medical attention.

How do I get my biopsy results?

The biopsy report is usually available in 1-2 weeks. Please call your referring doctor or make a follow-up appointment to discuss the results of the biopsy and what treatment if any is needed.

Do you have any additional questions?

If you have any other questions please feel free to call our office and ask, at 650-404-8445.  We want to ensure your comfort and understanding of the procedure to be performed. Thank you!

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