A kidney biopsy. Is it dangerous?
Kidney biopsy is a diagnostic procedure that takes a small piece of tissue through a thin needle for subsequent microscopic examination. Tissue is extracted by syringe at one end of the needle. This method allows to correctly form a diagnosis and choose appropriate treatment.
Renal biopsy: indications and contraindications
Indications for study:
- acute or chronic pathology of unknown etiology;
- complicated infectious diseases of the urinary tract;
- fast-paced glomerulonephritis;
- detection of blood in the urine or protein;
- detection in the blood increased amounts of nitrogenous wastes (uric acid, urea, creatinine);
- clarification of various pathological conditions of the kidneys detected by ultrasonography, CT;
- suspected cancer of the kidney or nephrotic syndrome;
- unstable operation of a transplanted kidney;
- establishing the severity of a disease, the damage;
- control over the effectiveness of prescribed therapeutic treatment.
Contraindications to renal biopsy are absolute and relative. Absolute contraindications:
- the patient has only one kidney;
- impaired blood clotting;
- is allergic to novocaine;
- revealed a tumor of the kidneys;
- diagnosed hydronephrosis, renal vein thrombosis or cavernous tuberculosis of the kidney;
- aneurysm of the renal artery.
Relative contraindications include the following States:
- diastolic hypertension severe (from 110 mm Hg. calendar);
- the last stage of General atherosclerosis;
- severe renal failure;
- the nodular periarteritis;
- pathological mobility of the kidney;
The advantages of the method
A biopsy is the most reliable method of diagnosing pathologies of the kidneys. Through the analysis of the tissue sample, the doctor can accurate diagnosis, assess the severity of the disease, to select appropriate treatment, to prevent side effects and complications.
Preparation for the examination
What does the doctor?
- Prescribes blood and urine tests to detect infections. Examines medical records for contraindications.
- Acquaints the patient with the reasons for the appointment of the renal biopsy, with the advantages of the method and possible risks.
- Gives the patient to sign the consent for the procedure and explains how to prepare for it.
What should the patient do?
- To find out from the doctor all the contentious issues, the answers to the questions.
- Tell your doctor about health status, diseases, pregnancy, allergies, sensitivity to certain drugs, taken at this time medications.
- In one to two weeks before the biopsy to stop taking blood thinners (aspirin, dabigatran, rivaroxaban, etc.).
- Week to stop taking painkillers because they affect blood clotting.
- Do not eat for eight hours before the procedure. Immediately before the biopsy do not drink.
Risks and possible complications
Prior to agreeing to a kidney biopsy, you need to know about the risks and possible complications. In this case they are minimal, but still have a place to be. The main risk – possible damage to the kidneys and nearby organs.
Other serious complications:
- bleeding (in one of ten cases are themselves, in one of the fifty biopsies require transfusion, one and a half cases may need surgery; one of three thousand biopsies require the removal of a kidney; very rarely – death);
- rupture of the lower pole of the kidney;
- purulent inflammation of adipose tissue around the organ;
- muscle bleeding;
- pneumothorax due to air entrapment in the pleuralcavity;
We have listed serious complications, which are rare. In most cases, the patient briefly feels the pain, slightly increased temperature after the biopsy.
How to conduct a kidney biopsy?
The procedure was carried out in a hospital, in a special room or operating room.
How is a biopsy?
The procedure takes about half an hour under local anesthesia. It happens – Chas and more. In some cases the patient enters into a state of light sedation: it's relaxed, half asleep, but can follow doctor's orders. Sometimes requires General anesthesia.
General rules for performing renal biopsy:
- the patient lies face down, placing the chest or belly pillow (in this position the kidneys are located at back surface);
- for the biopsy on the transplanted kidney, the patient lies on the back;
- medical staff throughout the procedure monitor blood pressure and pulse;
- the doctor cleans site of injection needle and injects an anesthetic.
Pain usually is minimal. Their intensity depends on the General condition of the patient.
How to take a biopsy?
In the surface region of the kidneys on the skin is a tiny incision where the doctor inserts a fine needle. The whole process is controlled by ultrasound, x-ray, computed tomography (CT) or magnetic resonance imaging. The doctor asks the patient to take a deep breath and hold for forty-five seconds of breath.
When the needle penetrates the skin to the kidney, you may feel a little pressure. And when a sample of tissue, you hear a click. It is produced by a spring device intended for needle insertion and sampling of tissue. These feelings should not be alerted or scare.
In some cases, the veins injected contrast agent, which shows important blood vessels and the kidney.
Sometimes you have to do two or three puncture to obtain a sufficient sample amount for analysis. When the fabric is taken, the doctor removes the needle, and the puncture site covered with a bandage.
Kidney biopsy: types
The following types of biopsies:
- Through the skin (needle under the control of the instrument is inserted through the skin).
- Open (kidney tissue is taken directly during the operation; for example, when removal of the tumor; open biopsy is performed when the patient has only one kidney or have bleeding).
- Urethroscopy with biopsy (shown if in the renal pelvis or ureter are stones, there are abnormalities or diseases of the upper urinary tract is the kidney transplanted; method is recommended for children and pregnant women).
- TRANS jugular biopsy (in one of the renal veins run the catheter; the method is recommended in patients with bleeding disorders, obesity, chronic respiratory failure, congenital anomalies of the kidneys).
The postoperative period
What happens after the biopsy procedure?
First, the patient will be offered a rest in bed for at least six hours.
Second, several times he measured the heart rate and blood pressure, checking the presence of blood in the urine.
Thirdly, you will need to drink plenty of fluids.
Fourth, within forty-eight hours to avoid physical exercise. For two weeks heavy lifting and strenuous activities.
By weakening the anesthesia, a patient may feel back pain that is mild analgesic. At the same day or the next (if all good) man goes home.
After the procedure, possible blood in the urine the first twenty-four hours. When bleeding lasts longer, you need to go to the doctor. Other indications for seeking medical help:
- do not stop orsevere pain in region of kidneys;
- inability to urinate;
- General weakness.
Alternative kidney biopsies diagnostic methods do not exist. None of the methods does not give such precise data.