【Learning Points】
- The purpose of a kidney biopsy is to obtain kidney tissue for pathological examination to establish a diagnosis of the underlying disease.
- Prior to a kidney biopsy, it is essential to assess clotting function and complete a consent form.
- After the biopsy, close monitoring of vital signs and observation of urine output are necessary.
- The day following the biopsy, a renal ultrasound is performed to confirm the absence of bleeding before discharge.
I.Percutaneous renal biopsy examination:
Undersonography-guidance, the doctor will do percutaneous renal biopsy by biopsy needle. This procedure will obtain very small portions ofthe kidneytissuefor making pathological diagnosis.
II.Indications:
- Nephrotic syndrome or nephritis.
- Unknown cause of acute kidney injury.
- Proteinuria or hematuria.
- Suspected rejection or unexplained renal function deterioration for graft kidney.
- Any indication which nephropathy.
III.Before the procedure:
IV.During the procedure:
V. After the procedure:
- Keep the supine position and under the sand bag compression for six hours at least (kidney transplant patients just compression for two hours). If necessary, please also rest in bed within 24 hours as possible.
- The nurse will closely monitor your blood pressure and heart rate to check any change of vital sign.
- During best rest, if you want to urinate, please use the urinal in the bed .
- Please notify the nurse to check any hematuria or blood clot, when you first time urinate after biopsy.
- Emerge with hematuria, painful sensation over puncture site, swelling, chills, hypotension, palpitation, night sweating, dizziness and any other symptoms, please inform us immediately.
- In the coming morning, the doctor will check renal ultrasound to ensure any hematoma or not.
- Without any discomfort and bleeding, you may be discharged after sonography. But please watch out any signs and symptoms of bleeding. With the above condition, please return to the outpatient department or emergent room.
IV.Noes for Patients of after discharge from the hospital:
- Without any discomfort and bleeding, you may be discharged after sonography. But please watch out any signs and symptoms of bleeding. With the above condition, please return to the outpatient department or emergent room.
- Any regular antithrombotic agents should not be taken within one week . If any question, please contact your doctor for confirmation the timing offtake medicine.
VII. Reference:
- Bonani, M., Seeger, H., Weber, N., Lorenzen, J.M., Wüthrich, R.P., Kistler, A.D. (2021).Safety of Kidney Biopsy when Performed as an Outpatient Procedure. Kidney Blood Press Res,46(3), 310-322. https://doi.org/10.1159/000515439. Epub 2021 Jun 2. PMID: 34077930.
- Schnuelle, P. (2023). Renal Biopsy for Diagnosis in Kidney Disease: Indication, Technique, and Safety. Journal of Clinical Medicine, 12(19), 6424. https://doi.org/10.3390/jcm12196424
- Ubara, Y., Kawaguchi, T., Nagasawa, T., Miura, K., Katsuno, T., Morikawa, T., ... Tsuruya, K.; Committee of Practical Guide for Kidney Biopsy 2020. (2021). Kidney biopsy guidebook 2020 in Japan. Clinical and Experimental Nephrology, 25(4), 325-364. https://doi.org/10.1007/s10157-020-01986-6