Kidney Biopsy

A Guide for Patients

Introduction
If your doctor wants you to have a kidney
biopsy, here are some things you should
know.

A kidney biopsy involves taking one or

more tiny pieces of your kidney tissue to
look at under a regular microscope and a
highly specialized electron microscope.

The kidney tissue may be taken in one of

two ways:
1. Percutaneous (means through the skin)
biopsy: This is done using a needle
placed through the skin over the kid-
ney and guided to the right place in
the kidney, usually with the help of
ultrasound.
2. Open biopsy: The kidney tissue is
taken directly from the kidney during
surgery.

The kidney tissue is sent to a doctor

(pathologist) who looks at it using special
microscopes. He or she will check for any
abnormal cells or signs of disease.

2 National Kidney Foundation

Reasons for doing a kidney biopsy
Some kidney problems can often be found
by blood and urine tests, a sonogram (an
image made by ultrasound) or other spe-
cialized x-rays, and a physical examination
rather than a biopsy. But, in some patients
with certain types of kidney disease, and
those with a kidney transplant that is not
working properly, a correct diagnosis can
only be made with a kidney biopsy.

Specific reasons to do a kidney biopsy include:

n Blood in the urine (hematuria) or protein
in the urine (proteinuria)
n Abnormal blood test results
n Acute or chronic kidney disease with
no clear cause
n Nephrotic syndrome (which happens
when the filtering units of the kidney are
damaged)

A kidney biopsy may also help to find:

n A particular disease to see if it gets better
with treatment or if it is getting worse. It may
also show a problem that cannot be cured,
but can be slowed down by other therapy.
n How much permanent damage has
happened in the kidney.
n Why a transplanted kidney is not working
well. It helps your doctor decide on further
treatment.
n A kidney tumor.
n Other unusual or special conditions.

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Your health care provider should explain
about the kidney biopsy. You should know
why it is necessary, the benefits and any
risks. You will be asked to sign a consent
(permission) form to make sure you are
aware of any risks. Be sure you under-
stand the risks before you sign the consent
form. You may want to write down a list of
questions about the biopsy (see page 11).

Risks of kidney biopsy

The risks of kidney biopsy are very small,
but they should be discussed with your
health care provider. As in other medical
and surgical procedures, certain compli-
cations may happen even though every
effort is taken to prevent them. A blood
transfusion may be needed if serious
bleeding occurs. Rarely, surgery may be
needed to fix a blood vessel that is dam-
aged during the procedure.

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How to get ready for the biopsy
For two weeks before the biopsy, you
should not take aspirin, over-the-counter
pain medicines such as ibuprofen,
naproxen, Advil®, Nuprin®, or other medi-
cines that may cause thinning of the blood.
These medicines can change the way the
blood clots and raise the risk of bleeding.
Blood and urine samples are usually taken
before the kidney biopsy to make sure you
do not have an infection or other condition.
Your doctor may also want you to change
other medications before the biopsy.

You may be told to not eat or drink for

eight hours before the procedure.

How the biopsy is done

A kidney biopsy is usually done in a hos-
pital. An overnight stay may be needed
to watch for any complications. You may
be awake with only light sedation, or
asleep under general anesthesia. You will
be lying face down with a pillow under
your rib cage. If the biopsy is done on a
transplanted kidney, you will be lying on
your back.

Percutaneous biopsy: The kidney is

found using a sonogram, x-ray images,
or both. Sometimes, an injection of dye
into your veins may be needed to help
the doctor find the kidney and important
blood vessels.

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Once the site for the biopsy is found,
your skin is marked, then cleaned where
the biopsy needle will be inserted. You
will receive a local anesthetic to numb
the area where the biopsy needle enters.
You will be asked to take in a deep
breath and hold it as the doctor puts in
the needle. When the needle pushes
through the skin to the kidney, you may
feel a “pop” or pressure. It is important
to stay still and to hold your breath
(about 45 seconds or less). Sometimes
two needle passes are needed to get
enough tissue for diagnosis.

Percutaneous kidney biopsy

Kidney

Biopsy
Needle

When enough kidney tissue is taken, the

needle is removed and a bandage is
placed over the needle puncture site.

The entire procedure, from start to finish,

usually lasts about one hour. Sometimes
the biopsy may take longer than an hour.

6 National Kidney Foundation

Open kidney biopsy: Some patients
should not have a needle biopsy
because they may have a history of
bleeding problems. For these patients,
an open operation may be done where
the surgeon can actually see the kidney
to get tissue for study.

After the test

You may need to rest in bed for 12 to 24
hours after the biopsy, as directed by the
doctor. Staying still on the bed helps to
heal the site where the kidney tissue was
taken and lessen the chance of bleeding.

Your blood pressure and pulse are

checked often to look for any signs of
bleeding inside your body, or other com-
plications. Blood tests are also done. You
may eat and drink fluids after the biopsy.
If your blood tests, blood pressure and
pulse are stable, you should be allowed
to leave the hospital the next day.

Your doctor will talk to you about physi-

cal activity and things to watch for after
going home from the hospital. Heavy lift-
ing, strenuous exercise, including contact
sports, and sexual intercourse should be
avoided for two weeks after the biopsy.

If you had an open biopsy, be sure to ask

your doctor for any specific instructions
you need to follow after the surgery.

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 TIPS

Tell your doctor if you have any of the

following after surgery:
n blood in your urine
n not able to pass urine
n worsening pain at the biopsy site
n fever

n feeling faint or dizzy

Test results
After the tissue sample is taken, work to
study the biopsy is really just beginning.
There are specially trained pathologists
and laboratories with specialized equip-
ment for reading and interpreting kidney
biopsies. You can ask your doctor about
your choices for a laboratory and ask if
they “specialize” in reading and interpret-
ing kidney biopsies. You may also want
to check with your insurance company
about coverage for this service. It often
takes three to five days to get the full
biopsy results. In some cases, you may
have a partial or full report within 24
hours or less.

Additional information
The following additional information on kid-
ney biopsy is available from the National
Kidney Foundation:
Online A to Z Health Guide on
Kidney Biopsy

8 National Kidney Foundation

www.kidney.org/atoz/atozItem
cfm?id=82

Online Fact Sheet: Ten Tests Used for

Diagnosing Kidney Disease

www.kidney.org/news/newsroom/
fsitem.cfm?id=5

THINGS TO REMEMBER

Before the biopsy:

n Talk with your health care provider
to make sure you understand the
need for a biopsy and the risks
and benefits.
n Sign a consent form.
n Tell your doctor about any allergies
you have and medicines you take.
n Avoid blood thinning medications
n Avoid food and fluid for eight hours
before the test.

After the biopsy:

n Follow your doctor’s instructions

n Rest in bed for 12 to 24 hours.
n Avoid blood thinning medications
n Report any problems, such as:
n bloody urine more than 24 hours
after the test
n unable to urinate
n fever
n worsening pain
n faintness or dizziness

www.kidney.org 9
 True or False Quiz
1. A kidney biopsy is done to check for
kidney disease or damage.
True_______ False_______
2. A biopsy means taking tiny pieces of tis-
sue to look at under a microscope.
True_______ False_______
3. A biopsy is not necessary to find kidney
problems in patients who have had a
transplant.
True_______ False_______
4. There may be some risks involved in a
kidney biopsy.
True_______ False_______
5. You will be asked to sign a consent form
before the procedure.
True_______ False_______
6. The entire kidney biopsy procedure
takes about 10 minutes.
True_______ False_______
7. Heavy lifting and strenuous exercise
should be avoided for two weeks after
the biopsy.
True_______ False_______
8. It’s okay to eat and drink right before
the test.
True_______ False_______
9. You should not take aspirin or other
blood thinning medications for two
weeks before the biopsy.
True_______ False_______
10. People with a history of bleeding
problems should have an open biopsy
instead of a percutaneous (through the
skin) biopsy.
True_______ False_______

How did you do? Go to page 11 for the answers.

10 National Kidney Foundation

 NOTES AND QUESTIONS

You may want to jot down some notes or ques-

tions to ask your doctor before the biopsy.

Answers to True or False Quiz

1. T 3. F 5. T 7. T 9. T
2. T 4. T 6. F 8. F 10. T

www.kidney.org 11
 More than 26 million Americans have chronic kidney disease, and most
don’t even know it. Millions more are at increased risk. The National
Kidney Foundation, a major voluntary health organization, seeks to
prevent kidney and urinary tract diseases, improve the health and
well-being of individuals and families affected by these diseases, and
increase the availability of all organs for transplantation. Through its
affiliates and divisions nationwide, the foundation conducts programs in
research, professional education, patient and community services, public
education and organ donation.

Supported by an educational grant from

National Kidney Foundation

30 East 33rd Street
New York, NY 10016
800.622.9010
www.kidney.org

© 2008 National Kidney Foundation, Inc. All rights reserved. 11-10-0106