Kidney Biopsy

What is a kidney biopsy?

A kidney biopsy is a procedure in which a medical provider removes a small sample of your kidney tissue to examine it for signs of disease. In most cases, they’ll use a biopsy needle to remove the tissue sample. But sometimes, they’ll take the sample during surgery.

Another name for a kidney biopsy is a renal biopsy.

Why would I need a kidney biopsy?

A healthcare provider may recommend a kidney biopsy to identify symptoms that may affect your kidneys that imaging, blood or urine (pee) tests can’t reveal, such as:

• Scarring.
• Inflammation.
• Protein deposits.
• Genetic (inheritable) disorders.

A kidney biopsy can also help a provider determine how well a transplanted kidney is working and monitor the progression of chronic kidney disease.

A provider may also recommend a kidney biopsy if you have:

• Abnormal blood test results.
• Damage to the tiny blood vessels (glomeruli) that filter your blood (glomerulonephritis).
• Blood in your pee (hematuria).
• Protein in your pee (proteinuria).

How serious is a kidney biopsy?

A kidney biopsy is a relatively safe procedure. It’s usually minimally invasive, and it shouldn’t take long to recover. A healthcare provider can tell you more about what to expect.

How should I prepare for a kidney biopsy?

You’ll meet with a healthcare provider before a kidney biopsy. They’ll review your health history and perform a physical examination. They may also order a blood test and pee test. If these tests reveal you have an infection, you may need to treat it before the procedure.

Tell the provider about all prescription and over-the-counter (OTC) medications you’re taking, including herbal supplements. Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) and certain herbal supplements can increase your risk of bleeding. You may need to stop taking certain medications up to one week before a kidney biopsy.

In some cases, you may receive specific directions on when to stop eating and drinking before the procedure. You’ll also receive instructions about which medications to continue and which to stop before the procedure.

Do they put you to sleep for a kidney biopsy?

Healthcare providers perform most kidney biopsies with sedation. A provider will give you general anesthesia or moderate sedation. With general anesthesia, you’re asleep and won’t feel pain. With moderate sedation, you’re awake but very relaxed and won’t feel pain.

What happens during a kidney biopsy?

A special team of healthcare providers will perform a kidney biopsy. The team usually includes:

• A doctor who specializes in medical imaging (radiologist) or a doctor who specializes in conditions that affect the kidneys (nephrologist).
• Nurses.

Providers usually perform kidney biopsies in a hospital. In most cases, they’ll instruct you to lie on your stomach on a surgical table so they can perform the procedure through your back. But if you have a transplanted kidney, you’ll lie on your back because they perform the procedure through your belly (lower abdomen). The provider will numb the area and give you moderate sedation or general anesthesia so you won’t feel pain.

The radiologist or nephrologist will take the sample through one of these approaches:

• Percutaneous biopsy. This is the most common type of kidney biopsy. They’ll numb your skin and insert a needle to take the kidney tissue sample. The provider may use ultrasound or CT imaging (computed tomography imaging) to guide the needle to the best location in your kidney. A percutaneous biopsy typically involves moderate sedation. But providers perform some percutaneous biopsies without sedation if you’re at risk or you don’t want it.
• Open biopsy. In an open biopsy, the provider will use a surgical knife (scalpel) to make a small cut (incision) in your skin, remove tissue from your kidney and close the incision with stitches. An open biopsy typically involves general anesthesia.

How long does a kidney biopsy take?

A kidney biopsy usually takes about an hour.

How painful is a kidney biopsy?

You’ll be numb during a kidney biopsy, so you shouldn’t feel pain or discomfort. After a percutaneous biopsy, you may feel sore for a few days. An open biopsy is usually more painful afterward. Most people start to feel better within a week.

What happens after a kidney biopsy?

After a kidney biopsy, you’ll move to a recovery room, where healthcare providers will observe you. Observation can last anywhere from a few hours to overnight. They’ll check your vital signs, conduct blood tests and monitor your pee. They’ll also make sure you can drink fluids and pee comfortably. In most cases, you can go home to rest once your providers determine you’re healthy enough and no longer require monitoring or tests.

The providers will then send your sample to a lab for examination and testing. A pathologist will process the sample and observe it under a microscope. They’ll then compile their findings into a report and send it to your provider. You should get the results of your kidney biopsy from your provider within a few days. In urgent cases, you may get the results within a day.

How long is bed rest after a renal biopsy?

You may need up to a day of bed rest after a kidney biopsy to help reduce your risk of bleeding and promote healing. A healthcare provider will tell you exactly how much bed rest you need.

Can I drive home after a kidney biopsy?

The medications that healthcare providers use during a kidney biopsy can stay in your body for up to a day and make you feel drowsy. You must have a family member or friend drive you home.

What are the benefits of a kidney biopsy?

The main benefit of a kidney biopsy is that it can reveal conditions that affect your kidneys. It can also tell healthcare providers how well a donated kidney is working after a kidney transplant.

What are the risks or complications of a kidney biopsy?

Kidney biopsy risks are small, but complications can occur. You may experience bleeding after the procedure, including blood in your pee (hematuria). Healthcare providers will monitor you for a few hours to ensure you don’t have severe bleeding, which may require further treatment.

Other kidney biopsy risks may include:

• Dizziness.
• Fever.
• Inability to pee (urinary retention).
• Pain at the biopsy site.
• Urinary tract infection (UTI).
• The biopsy sample isn’t enough to make a diagnosis (nondiagnostic).

How long does it take to recover from a kidney biopsy?

Percutaneous biopsy pain usually starts to go away within a few days, while open biopsy pain may take a week or longer. A healthcare provider may prescribe pain relievers or recommend over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). It’s important to remember that your body is unique, and your recovery time may be different than others. Follow your healthcare provider’s instructions to encourage healing.

You should avoid heavy lifting and strenuous activities (including sports) for one to two weeks. Talk to a healthcare provider before resuming any activity.

When can I go back to work/school?

You should be able to return to work or school a day or two after a percutaneous kidney biopsy. An open biopsy may require you to stay home for at least a week.

When should I call a healthcare provider?

Call a healthcare provider or go to the nearest emergency room if you have:

• Signs of an infection, including a high fever (100.4 degrees Fahrenheit or 38 degrees Celsius) or discoloration (red, purple or brown), swelling or a headache.
• Blood in your pee more than 24 hours after the procedure.
• Difficulty peeing.
• Sudden, strong needs to pee (urgency).
• Pain or a burning feeling when you pee (dysuria).
• Feelings of weakness or dizziness.

What questions should I ask a healthcare provider before a kidney biopsy?

You may want to ask your provider:

• Why do you recommend a kidney biopsy?
• Do I need a percutaneous biopsy or an open biopsy?
• What kind of anesthesia do you recommend?
• How should I change my medications before a biopsy?
• When should I expect my results?

A note from Cleveland Clinic

A kidney biopsy is a procedure in which a healthcare provider removes tissue from your kidney to check its health. It can be stressful to hear that you need a kidney biopsy, especially while you wait for results. Talk to a healthcare provider. They understand your feelings and are available to answer any questions you may have.