Is a biopsy done on kidney too risky?
Patient: My cousin has had several blood and urine test to determine the reason for or changes to her kidney function. Her Dr is now recommending a biopsy be done. Should they do some other testing before this is done, as I have read that it is a bit risky. We are all new to this issue Doctor: Kidney biopsy is an invasive procedure in which a small amount of kidney tissue is retrieved with the help of a biopsy needle/biopsy gun and microscopical examination is done. This is done under local anesthesia. This is usually done when clinical examination, blood investigations (routine and specific) and imaging investigations are not enough to give a definitive diagnosis.A few investigations may be done before the procedure like Platelet, Prothrombin Time, APTT and bleeding time, which indicates the coagulation profile. Some nephrologists prefer the subject to be off medications like Aspirin and Warfarin. Post procedure, the subjects lie flat on their back for 4–6 hours to minimise the risk of bleeding. Vital parameters and urine are frequently monitored to ensure the patient is not suffering any bleeding complications.Complications are uncommon and may consist of minor bleeding from the biopsy site and in some cases there there may be haematuria (blood in urine). Pain at the biopsy site may occur, which may be relieved with anti-inflammatory agents like Paracetamol. Very rarely, severe complications like perinephric hematoma, Urinary retention (due to blood clot) and shock (due to sudden brisk bleeding) may occur.Your Nephrologist will give an overview about the procedure and the pre-procedure tests required, and the patient's NOK may have to sign a consent form for the procedure.