In the article, consider what it is - a kidney biopsy. It is an informative diagnostic procedure, which involves using a special syringe to obtain biomaterial from an organ. Based on a histological study of tissues, specialists will have an idea of the complete picture of the disease, an accurate diagnosis and the desired treatment plan.
Patients are quite wary of the upcoming biopsy - they are afraid of pain and complications after the procedure. So great is the convincing power of word of mouth.
Indications for the purpose of the study
Many patients are interested in what are the indications for a kidney biopsy. The diagnostic procedure is prescribed for:
- Complicated urinary infections.
- Chronic or acute pathological processes in the kidneys that have an unclear etiology.
- The presence of protein in the urine.
- Rapidly developing glomerulonephritis.
- The presence of nitrogenous toxins in the blood (creatinine, urea or uric acid).
And:
- In order to confirm the pathology detected in the process of ultrasound or computed tomography.
- To confirm or refute nephrotic syndrome or kidney cancer.
- The study is necessary in order to identify the stage of development and the severity of pathological processes in the kidneys.
- With unstable impaired activity of the implanted kidney.
- If you need to evaluate the therapeutic effectiveness of the prescribed treatment.
Renal biopsy is considered the most reliable diagnostic method in identifying various diseases, but even this fact does not exclude the presence of contraindications to this study.
How is a kidney biopsy done? This will be discussed below.
In what cases is the procedure contraindicated?
But even such a diagnostic method, useful in all respects, which has the highest information content, has certain contraindications.
Categorically, a puncture biopsy of the kidneys should not be performed if:
- Only one kidney is functioning.
- There is poor blood coagulation.
- There is an allergy to drugs based on novocaine.
- There is a renal tumor.
- Diagnosed with an artery aneurysm in the organ.
- With renal cavernous tuberculosis, venous thrombosis or hydronephrosis.
In addition, myelomic processes, severe forms of diastolic hypertension, the last stages of atherosclerosis, renal failure, nephroptosis or pathological renal motility, periarteritis nodosa, etc. are a relative contraindication to kidney biopsy. So, how is a kidney biopsy performed?
Types of this procedure
A kidney biopsy can be done using several methods:
- Open. With this technique, an incision is made over the place where the kidney is located, then a small piece of tissue is taken for examination. Typically, an open technique is used if volumetric tissue removal is required. Today, this type of biopsy is often performed using laparoscopy, because it has a low invasiveness.
- Percutaneously. This type is carried out by a specialized needle, which is inserted through the skin above the kidney under ultrasound or x-ray control. Sometimes, with this procedure, a contrast medium is used to visualize the kidney and vascular network at the puncture site. How is a kidney biopsy taken?
- Transjugally. During this procedure, a catheter is used, which is launched into the renal vein. This method of taking a biopsy is recommended for people with bleeding disorders, obesity or respiratory failure.
- Urethroscopy with a biopsy specimen is usually prescribed for calculi in the renal pelvis or ureter. This type of procedure is performed under operating conditions, using general or spinal anesthesia. A long flexible, thinest tube is introduced through the urethra, it is led to the kidneys along the urinary tract, and then a biopsy specimen is taken.
Retroperitoneoscopic tactics are considered another type of kidney surgery. Unlike an extensive abdominal operation, this procedure is carried out through small punctures. Laparoscopy is performed through the surface of the abdomen, while retroperitoneoscopic surgery is performed through the lumbar region. A biopsy is also done in these cases.
A specific method is selected individually for each patient. The specialist takes into account the condition of the patient, the purpose of the biopsy, the possibility of a clinic, and more.
How to prepare for the procedure
The doctor is informed the patient about the suspicions that caused the biopsy, as well as the likely risks and complications.
The medical institution and the patient conclude an agreement on the consent to the diagnostic procedure, the document says that the patient is aware of the possible consequences.
Then the doctor finds out the presence of various diseases, allergies and intolerance to drugs. The patient should tell the doctor about all the drugs that he takes.
In general, to prepare for a biopsy, the following is carried out:
- 1-2 weeks before the procedure, “Aspirin”, “Rivaroxaban”, “Dabigatran” and other medicines that can thin the blood stop taking.
- Submit blood and urine tests before a kidney biopsy in order to exclude infectious lesions and identify contraindications.
- Eating is stopped 8 hours before the manipulation, and immediately before it do not drink liquid.
- Pain medications, such as Naproxen, Ibuprofen, are also not recommended, since these drugs have an effect on blood coagulation and increase the likelihood of bleeding.
Procedure
How a kidney biopsy is done is important to find out in advance. The diagnostic procedure is carried out in a hospital in the treatment room or operating room.
The biopsy does not last long, the total duration is 30 minutes.
The patient is located on the couch with his stomach down, equipment for controlling pressure and pulse is connected to it. All manipulations are controlled by magnetic resonance or computed tomographs, x-ray or ultrasound apparatus:
- First, the specialist determines the place of insertion of the biopsy needle, the area around is chipped with anesthetics.
- Then the patient should take a deep breath, hold his breath for 45 seconds.
- When the needle is inserted, patients feel a slight pressure, after which a clicking sound is clearly audible. This suggests that a puncture of the renal membrane and sampling of material has taken place. The biopsy sample is taken with a special device, which, when tightening the biomaterial, produces a clicking sound.
- When the doctor has collected the necessary amount of biopsy, the needle is carefully removed.
- The puncture site is treated with an antiseptic and closed with a sterile dressing.
The patient will be transferred to the ward after the procedure, because he needs bed rest for 6-7 hours. All this time, his physical condition is controlled by doctors.
When the action of anesthetics ceases, a person may feel pain in the puncture area. A few hours after a kidney biopsy, the patient's urine is examined for blood impurities.
In the presence of glomerulonephritis
What is a kidney biopsy for glomerulonephritis? The technique is widely used if the patient is suspected of such a disease. Only by this type of diagnosis can the picture of the state of the kidneys be clarified and the exact nature of the changes that occurred in the tissues can be determined.
Thanks to microscopic, immunofluorescence and morphological studies of the biopsy specimen, it is easy to identify lesions of various types:
- Minor changes characterized by minimal tissue destruction.
- Membranous type of nephritis with epithelial renal tubular dystrophy.
- The proliferative nature of glomerulonephritis, which accompanies intracapillary proliferation.
- Chronic progressive form of glomerulonephritis, it is considered the final stage of pathology.
A common reason for a kidney biopsy is a change in the characteristics of urine and its structure (qualitative and quantitative). Based on the results of the study, the doctor will select an effective treatment regimen that promotes the patient's rapid recovery.
Kidney Biopsy Results
They will be ready in a few days, but if the goal of the biopsy is to determine the infection or inflammation, then the patient will have to wait 2 weeks.
What is the norm in this case?
The results are considered normal if any manifestations of the tumors, as well as infectious lesions, scars and inflammations are absent.
If the biopsy revealed cicatricial changes, then this may indicate systemic lesions, pyelonephritis, glomerulonephritis and other diseases.
Possible complications
The most common renal biopsy complications are listed below. They include experts:
- Internal bleeding, which eventually goes away on its own.
- Severe bleeding requiring a blood transfusion.
- Severe bleeding. To eliminate it, an operation is performed.
- Breakthrough in the kidney.
- Purulent pyelonephritis, which is accompanied by inflammatory lesions of the lipid perinephric tissues.
- Pneumothorax.
- I’ll lose my kidneys.
- Muscle bleeding.
- Infections
Life-threatening conditions
The following conditions are considered very serious, you need to urgently contact a medical institution:
- If the patient feels general weakness, he does not feel the restoration of strength, cannot even carry out simple actions without intense tension. When you try to get up or walk a short distance, dizziness occurs. This is far from the norm, and it is not worthwhile to attribute this to the weakening of the body that arose after the biopsy.
- A person has a weak urination. This should also alert. The processes of urine waste should not be disturbed. When the doctor has done everything correctly, this function will not be affected.
- An emergency visit to the hospital is necessary if severe and intolerable renal pain occurs, the body temperature rises, and fever begins.
Now it’s clear what it is - a kidney biopsy.
Recovery period
All medical recommendations must be followed without fail. When the patient returns home, he will have to follow a certain regime:
- Lie in bed for 2-3 days.
- Drink plenty of fluids.
- Exercise should be avoided for two days.
- Antibiotics and hemostatic drugs should be taken as a preventive measure.
- From sports and weight lifting should be abandoned for 1-2 months.
If the patient’s pressure rises during the recovery period, he experiences terrible renal pain, fever is observed, or pus or blood appears in the urine, it is necessary to visit a nephrologist as soon as possible.
Patient Reviews
People often have kidney pathologies. In this case, many specialists have to go through, including an oncologist. A kidney biopsy, according to reviews, is considered an effective and very informative procedure. The procedure is almost painless, complications are extremely rare.
The comments also reported that sometimes pain after manipulation is present, but it is tolerable and disappears in a few days. So kidney biopsies should not be feared.
The price of the procedure and where can it be done?
The renal biopsy procedure is carried out in highly qualified private clinics, specialized medical centers and multidisciplinary hospitals, for this it is necessary to have a professional and trained staff.
Puncture percutaneous biopsy on average costs about 2300-2400 rubles. It depends on the region and type of clinic.
We examined what it is - a kidney biopsy.