What is Open Kidney Biopsy

Open kidney biopsy is a procedure to remove small pieces of tissue from a kidney. This procedure is done so that the tissue can be examined under a microscope and checked for disease or infection.

During this procedure, a small incision will be made in your abdomen to access the kidney. The health care provider will remove a piece of kidney tissue, then he or she will use stitches (sutures) to close the incision.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs.
• High blood pressure (hypertension) due to swelling of blood clots (Page kidney).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• You will have blood and urine samples taken. These will be tested to make sure that you do not have a condition that may make a biopsy unsafe for you.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• A small incision will be made on the side of your abdomen.
• A tool called a retractor will be used to spread open your skin, muscle, and fat. This will allow the health care provider to see your kidney clearly.
• A needle will be used to take a tissue sample from your kidney (needle biopsy). In some cases, a small incision may be made on the kidney to remove a piece of tissue.
• Any incisions made on the kidney will be closed with sutures.
• The incision in your abdomen will be closed with sutures. The incision may be covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will need to lie on your back for 6–8 hours.
• You may have some pain or soreness near the incision.
• You may have fatigue or trouble thinking and moving (grogginess) if you had general anesthetic.
• You may have pink or cloudy urine from small amounts of blood. This is normal.
• It is up to you to get the results of your procedure. Ask your health care provider, or the department that is doing the procedure, when your results will be ready.

Summary

• An open kidney biopsy is a procedure to remove small pieces of tissue from a kidney. This procedure is done so that the tissue can be examined under a microscope and checked for disease or infection.
• After the procedure, you will need to lie on your back for 6–8 hours.
• Plan to have someone take you home from the hospital or clinic. 
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider, or the department that is doing the procedure, when your results will be ready.

Open Kidney Biopsy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain or soreness near the incision.
• Bright pink or cloudy urine for 24 hours after the procedure. This is normal.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider tells you that it is safe.
• Avoid activities that may put pressure on your abdomen, such as forceful coughing or straining.
• Avoid activities that take a lot of effort (are strenuous) until your health care provider approves. Most people will have to wait 2 weeks before returning to activities such as exercise or sexual intercourse.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• You may eat and drink after your procedure. Follow instructions from your health care provider about eating or drinking restrictions.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have blood in your urine more than 24 hours after your procedure.

Get help right away if:

• Your urine is dark red or brown.
• You have a fever.
• You are unable to urinate.
• You feel burning when you urinate.
• You feel like you may faint.
• You have severe pain in your abdomen or side.

Summary

• After the procedure, it is common to have pain or soreness near the incision.
• Bright pink or cloudy urine for 24 hours after the procedure is also normal.
• Contact your health care provider if you have worsening pain, signs of infection, or blood in your urine more than 24 hours after your procedure.