Kidney biopsy, a variety of procedures and methods of organization
Kidney biopsy is a diagnostic examination that provides small samples of kidney tissue with a needle for later examination under a microscope. Biopsy makes it possible to identify and select the correct treatment of pathology. When a kidney biopsy is performed on the other end of the needle, there is a syringe that collects the tissue in the needle.
Species of the
- examination. A kidney biopsy is a removal of a tissue of the kidney with a puncture needle that is inserted under the skin and back muscles. This method of diagnosis is carried out in a hospital under local anesthesia and in the control of ultrasound. It is organized for the diagnosis of a tumor in the kidney, amyloidosis and other lesions in order to select effective treatment tactics or to monitor the condition of the donor kidney after transplantation. The most common complication is bleeding and the formation of a hematoma near the kidney.
- An open-label diagnostic method used to collect kidney tissue samples. An open kidney biopsy is an operation when the tissue for examination is taken directly from the kidney during surgical intervention under general anesthesia. The cut in this case is done on the side or back. An open biopsy is organized when it is required to remove most of the tissue. Also, the method can be performed with only one functioning kidney in order to reduce harm to it. An open biopsy is indicated for patients with circulatory problems and recently it has been laparoscopically organized, so it has become less traumatic.
- Urethroscopy with biopsy - this diagnostic method is usually performed if stones are present in the kidney of the kidney. Urethroscopy is performed in the operating room under spinal or general anesthesia. An elongated thin tube is inserted to examine the internal part of the ureter, the lower part of the kidneys and the pelvis of the kidney. In addition, ureteroscopy with biopsy is organized for children, pregnant women, patients with an abnormal structure of the upper urinary tract, patients with a transplanted kidney.
- Transhumid - is organized in case of the possibility of launching a catheter into the renal vein. Such a diagnostic method is used for patients with blood coagulation pathologies, when percutaneous renal biopsy becomes impossible. The same applies to patients with excess body weight or chronic insufficiency of breathing, when anesthesia can cause great harm. There are situations when the anatomical location of the kidneys and their size makes it impossible to conduct a routine biopsy.
Biopsies are recommended in the following cases:
- appearance of blood in the urine or hematuria;
- detection in urine of high protein concentration;
- increase in nitrogenous slag in the blood in connection with the weakening of the kidneys.
Indications for the organization of a biopsy
Conducting a biopsy of the kidneys is prescribed in the following situations:
- biopsy in acute and chronic renal pathologies of unexplained etiology;
- biopsy in case of suspicion of nephrotic syndrome;
- kidney biopsy with glomerulonephritis;
- complex forms of infectious lesions of the urinary canals;
- problems with kidney function established by ultrasound examination, kidney analysis and computed tomography;
- kidney tumor biopsy;
- problems of functioning of the transplanted kidney;
- revealing the severity of the pathology and the irreversibility of the changes that occurred in the organ;
- control of the effect of the organized treatment.
Preparing for
procedure Beforehand, the attending physician must explain to the patient the reasons for the kidney biopsy. The patient should clearly understand the advantages and risks of the procedure, he can ask the expert all the questions he is interested in, and then sign an agreement on manipulation and confirmation of familiarization with the risks in case of complications.
The patient in turn should clearly describe to the doctor his state of health, the presence of pathologies, allergic reactions, intolerance to any medications. It is necessary to inform about taking medications at the time of the biopsy.
This is important!
One to two weeks before a kidney biopsy, you need to stop taking medications that dilute the blood, such as aspirin and others. You will also need to stop taking pain medication - ibuprofen, naproxen, because they also affect the properties of blood clotting and may increase the risk of severe bleeding.
It is forbidden to drink liquid just before the procedure and eight hours before it is better to refuse to eat at all.
Before the procedure, urine and blood tests are performed to identify contraindications and the presence of infections.
Conduction of kidney biopsy
Kidney biopsy as a diagnostic method is carried out in a closed or operative manner.
If it becomes impossible for the patient to achieve complete normalization of blood pressure, hemorrhagic syndrome and hypocoagulation. For him, a transgular endoscopic biopsy or an open kidney biopsy is performed.
The method of obtaining tissue samples will depend on the structure of the puncture needle. Along with traditionally accepted in medicine manual methods, automatic special needles are increasingly being used.
This is important!
In describing the procedure and answering the question of how a kidney biopsy is done, specialists remind that after the procedure an ultrasound monitoring of the condition of the examined kidney will be required.
In order to prevent the development of complications, the patient should lie on the ice bubble for three hours after the completion of the puncture. And in the next two days - to observe a strict bed rest. Also, the administration of hemostatic drugs and antibiotic drugs is prescribed.
Consequences of kidney biopsy
After completing the biopsy procedure, the patient will need to rest for at least six hours. Pulse and blood pressure will be kept under control. And when urinating, urine is checked for bleeding. At this time it is allowed to start a habitual diet and it is recommended to consume a lot of liquid.
After a biopsy, patients with a transplanted kidney should lie on their backs for several hours.
If the effect on the body of anesthesia is weakened, the patient may feel minor back pain due to minor trauma. Pain can be removed with mild analgesics. If after a biopsy state of health quickly normalizes, then on the same day it is allowed to return home.
This is important!
When implementing an open biopsy, you should always consult a doctor for specific instructions that you will need to follow when the operation is completed.
Also after a biopsy, you must give up physical activity and exercise for 48 hours. Avoid strenuous activities and carrying heavy loads for the next two weeks. If the bleeding does not end one day after the operation, then you need to visit a doctor.
Also the indications of a referral to a specialist will be:
- inability of normal urination;
- febrile state;
- persistent pain in the kidney;Dizziness and severe weakness.