What is Percutaneous Kidney Biopsy

A kidney biopsy is a procedure to remove small pieces of tissue from a kidney. In a percutaneous biopsy, the tissue is removed using a needle that is inserted through the skin.

This procedure is done so that the tissue can be examined under a microscope and checked for disease or infection.

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.
• Damage to other structures or organs.
• Swelling from a collection of clotted blood outside a blood vessel (hematoma).
• Blood in the urine (hematuria).

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• 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 before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.
• You will have blood and urine samples taken. This is to make sure that you do not have a condition where you should not have a biopsy.
• Plan to have someone take you home from the hospital or clinic.
• Ask your health care provider how your biopsy 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.
  • Your skin will be washed with soap.
• An IV tube 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).
• You will lie on your abdomen. A firm pillow will be placed under your body to help push the kidneys closer to the surface of the skin. If you have a transplanted kidney, you will lie on your back.
• The health care provider will mark the area where the needle will enter your skin.
• An imaging test—such as an ultrasound, X-ray, CT scan, or MRI—will be used to locate the kidney. These images will also help the health care provider to guide the biopsy needle into the kidney.
• You will be asked to hold your breath and stay still while the health care provider inserts the needle and removes the kidney tissue.
  • You will need to hold your breath and stay still for 30–45 seconds.
  • During the biopsy, you may hear a popping sound from the needle.
  • You may also feel some pressure from the area where the needle is being inserted.
• The needle may be inserted and removed 3 or 4 times to make sure that enough tissue is taken for testing.
• A bandage (dressing) may be placed over the spot where the needle entered your skin (biopsy site).

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 biopsy site.
• You may have pink or cloudy urine from small amounts of blood. This is normal.
• You may have grogginess or fatigue if you were given a sedative.
• Do not drive for 24 hours if you were given a sedative.
• It is up to you to get the results of your procedure. Ask your health care provider, or the department performing the procedure, when your results will be ready.

Percutaneous 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 area where the needle went through your skin (biopsy site).
• Bright pink or cloudy urine for 24 hours after the procedure.

Follow these instructions at home:

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 drive for 24 hours if you were given a medicine to help you relax (sedative).
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider tells you that it is safe.
• 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.
• Check your biopsy site every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• 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 biopsy site.
• You have more fluid or blood coming from your biopsy site.
• Your biopsy site feels warm to the touch.
• You have pus or a bad smell coming from your biopsy site.
• You have blood in your urine more than 24 hours after your procedure.

Get help right away if:

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