The Kidney Biopsy

So after a few months of testing from my Primary Care doctor and handing me off to a Nephrologist, I was finally sent for a Kidney Ultrasound and a Kidney Biopsy in April 2016.  The ultrasound was just used for getting a measurement of the kidneys and to rule out anything foreign on the kidneys such as tumors or disease.  I am happy to say my kidney ultrasound results were good.

My kidney biopsy was pretty much a breeze.  I arrived at the hospital and was sent to the Cath Lab.  The specialized doctors would be using a CT scan to guide them through the biopsy process.  Here are the steps of a kidney biopsy:

Percutaneous biopsy

Percutaneous means through the skin. Most kidney biopsies are done this way. The procedure is usually done in the following way:

• You may receive medicine to make you drowsy.
• You lie on your stomach. If you have a transplanted kidney, you lie on your back.
• The doctor marks the spot on the skin where the biopsy needle is inserted.
• The skin is cleaned.
• Numbing medicine (anesthetic) is injected under the skin near the kidney area.
• The doctor makes a tiny cut in the skin. Ultrasound images are used to find the proper location. Sometimes another imaging method, such as CT, is used.
• The doctor inserts a biopsy needle through the skin to the surface of the kidney. You are asked to take and hold a deep breath as the needle goes into the kidney.
• If the doctor is not using ultrasound guidance, you may be asked to take several deep breaths. This allows the doctor to know the needle is in place.
• The needle may be inserted more than once if more than one tissue sample is needed.
• The needle is removed. Pressure is applied to the biopsy site to stop any bleeding.
• After the procedure, a bandage is applied to the biopsy site.

Now my first biopsy was done in Augusta Georgia. I was taken into a room with a big CT scanner. I had to lie on the table face down.. A scan was taken of my back and kidney area to help the doctor visualize where to put the needle.  I was given medicine that put me to sleep and when I woke up I was in the recovery room, in a bed under a nice warm blanket. You are required to lay on your back for about 8 hours after the biopsy. Vitals are taken as needed as well as  blood tests to check for anemia. One of the complications that can happen with a kidney biopsy is a risk of bleeding too much. The kidneys filter all of the bodies blood and is a very vascular organ. After a biopsy puncture the doctors want to make sure that your blood is clotting and you are not still bleeding. This is done visually, as the nurse looks around your bandage site several times while you are in recovery and internally, you might say, through hemoglobin count blood tests. Unfortunately for me because my anemia had not been addressed yet, my hemoglobin was quite low. I had to stay overnight in the hospital until my hemoglobin reached 9. Later the next day it did and I was able to go home. Once you are home you are instructed to take it easy for about a week and not lift anything more that 10 pounds. It takes about a week or two for your doctor to get the lab results back. The kidney samples are sent off to a very specialized lab where they look for several markers for various kidney diseases. In my case it was noted that the filters, or glomeruli, of the kidneys were clogged with inflammation.

Photo from UNC Kidney Center

In the colored picture you can see a slice of one filter.  The red blood cells (hematuria) and small yellow dots (Protein/Proteinuria) are leaking out through a damaged kidney filter (glomeruli) into urine.   

IgA is characterized by the hematuria it causes, which just means blood in the urine. This blood may be visible to the naked eye or only seen under a microscope. Over time this disease can damage the kidney’s ability to clean the blood properly. Most people with this disease lose kidney function very slowly, or not at all.  Of course I was crossing my fingers for the not at all part!

I will talk more about IGA Nephopathy in another blog post. Thanks for reading!

Disclaimer:  I am not a doctor.  I am not a medical professional.  NO information on this site should be used to diagnose, treat, prevent or cure any disease or condition.