Kidney Biopsy Tips

Introduction

The kidney biopsy is an important tool in diagnosis and monitoring kidney disease. It is an invasive procedure with significant risks and financial costs. To get the best results with the least amount of stress/anxiety, there are a number of things you need to do.

1. Understand the Indications:

• Do you have blood in your urine?
• Do you have protein in your urine?
• Are your kidneys failing?
• Is your kidney disease progressing?
• Is your kidney disease not responding to treatment?
• Is your kidney transplant rejecting?

2. Understand How It Is Going to Help:

• What is your doctor looking for?
• Is it really important to make a specific diagnosis
• Is the biopsy going to change how your doctor treats you?
• Is it important to know the prognosis?

3. Learn If You Have Any Contraindications:

• Do you have shrunken or scarred kidneys?
• Do you have only one kidney?
• Do you have an uncorrectable bleeding condition?
• Do you have severe or uncontrollable high blood pressure?
• Do you have many cysts in both kidneys?
• Do you have a kidney mass or tumor?
• Do you have a kidney obstruction ?
• Do you have an active infection in or near the kidneys?

4. Know the Risks:

• How much pain can are you expecting?
• What is the risk of bleeding?
• What is an arteriovenous fistula?
• What is the risk of getting a serious infection?
• What is the risk of puncturing a lung or another organ?
• What is the risk of death?

5. Make Sure To Get Your Questions Answered:

• What tests do I need first and when should I get them?
• When do I stop eating and drinking beforehand?
• What medications should I or should I not take beforehand?
• What does the procedure involve?
• Who is going to perform the procedure?
• How often is there a problem getting enough tissue to make a diagnosis?
• What pain medications will I be given afterwards?
• What can I expect after the procedure in the hospital?
• Will I being staying overnight in the hospital?
• What restrictions will I have afterwards?

6. Make Sure Your Doctor Knows Everything:

• If you have had bleeding problems in the past.
• If you take aspirin, blood thinners, NSAIDS or other anti-inflammatory drugs.
• If you are allergic to any medications including anesthetics.
• If you might be pregnant.

7. On the Day Before the Biopsy, Make Sure to:

• Have a ride home arranged if you are leaving the same day.
• Have new prescriptions filled.
• Have medical insurance issues settled, if there are any.
• Check that the radiology department has you on their schedule.
• Check that the hospital still has a room for you if you are staying overnight.
• Check that your doctor’s admission note (H&P) and orders have arrived.
• Know where to check in.

8. On the Morning of the Biopsy, Make Sure to:

• Avoid food and fluids as directed.
• Take your medications as directed.
• Arrive early and at the right place.
• Get your blood tests if not already done.

9. After the Procedure, Make Sure to:

• Rest in bed on your back for at least 6 hours.
• Call your nurse if you are in a lot of pain or something is “wrong”.
• Call your nurse to see the urine before you throw it out or flush it.

10. After Going Home, Make Sure to:

• You are available by phone for the first 3 days.
• Don't do any “bouncing” activities such as jogging, aerobics, etc. for a couple of weeks.
• Schedule a follow-up doctor appointment to get the results.

11. Know When to Call Your Doctor

• If you have blood in your urine after 24 hours.
• If you have worsening pain in your back, abdomen or groin.
• If you develop a fever.
• If you have a lot of bleeding or pus from the biopsy site.
• If you develop increasing tenderness/pain at the biopsy site.
• Get weak or lightheaded when standing up.