What are the methods of kidney biopsy?

Kidney diseases make up the majority of all chronic pathologies. Timely diagnosis of the process improves the prognosis of the disease. In the diagnosis of kidney pathologies, the main role belongs to ultrasound, which is the gold standard for diagnosing the condition of the kidneys, as well as CT, radiography with contrast, and kidney biopsy. What can be found with a kidney biopsy? How the procedure is carried out, and what preparation is needed for the procedure, read on estet-portal.com.

What is the informational value of a kidney biopsy?

Kidney biopsy helps separate primary nephritis from nephropathy. Also, its results can refute the initial diagnosis, completely changing it and the methods of treatment used. Thus, the overall strategy for the treatment of kidneys depends on it, as well as the tactics of surgical therapy for UPS and certain types of hypertension.

For example, based on the results of a kidney biopsy, the doctor can decide whether the patient needs surgery – renal artery angioplasty or nephrectomy.

Puncture kidney biopsy is also important in determining the need for kidney transplantation. After all, with its help, contraindications are revealed. Also, a kidney biopsy can determine the effectiveness of a liver transplant in hepato-renal failure, confirming or disproving the diagnosis of hepatorenal syndrome or ANO (acute tubular necrosis).

In some cases, repeat biopsies are also useful to help control the prescribed therapy.

What  methods of kidney biopsy are used?

Kidney tissue can be taken for analysis in two ways: closed (through the skin) and open. The first has been in use since the 1980s. In most cases, it passes under ultrasound guidance. However, there may be exceptions here too. For example, if the patient is overweight, computed tomography will be more effective.

There are several other methods for performing a kidney biopsy. Each of them has its own characteristics and technique of execution. Let's consider them in more detail.

Basic methods for performing a kidney biopsy:

• Puncture biopsy of the kidneys – the kidney tissue is taken with a puncture needle, which is inserted through the dorsal muscle. This method is performed under local anesthesia in a hospital under ultrasound control.
• Ureteroscopy with biopsy – carried out in the presence of kidney stones in the pelvis. This method requires anesthesia. A thin tube is inserted into the ureter to visualize the lower part of the kidneys and the pelvis.
• Open kidney biopsy – Kidney tissue is taken during surgery under anesthesia. The incision is made on the side or back. This method is used when it is necessary to remove most of the tissue. Recently, the procedure has been performed laparoscopically. An open kidney biopsy is performed only in cases where it is not possible to achieve full stabilization of blood pressure, blood clotting and symptoms of hemorrhagic syndrome. For tissue sampling for biopsy in this way, the use of automatic needles is now being introduced.
• Transjugular – carried out when it is possible to launch a catheter into the renal vein. This method is used for pathologies of blood coagulation in a patient, when a biopsy through the skin becomes impossible due to overweight or chronic respiratory failure.

What is the preparation for a kidney biopsy?

Preparation for the process of taking material for analysis of renal tissue must necessarily include several important steps. The very first of them – identification of contraindications. What follows is a definition of the most important indicators.

These include blood coagulation, Rh factor, blood type, and important functional features of the kidneys, such as their position and mobility. Intravenous urography is necessary. And if it is contraindicated, ECHO or ultrasound are used.

The doctor explains the purpose and methodology of the procedure. For 2 weeks before a kidney biopsy, the patient is prohibited from taking blood thinners and painkillers, which also affect the blood condition.

Further, before performing a kidney biopsy, correction of such important indicators as blood pressure and anemia must necessarily follow.

As for the control after the procedure, it must include the following items:

• ultrasound examination immediately after sampling;
• 3 hours patient on ice pack;
• Assigning the patient to bed rest for the next two days.

Gross hematuria may be a possible complication after a kidney biopsy. However, the overall rate of significant complications is 3.6%. Thus, kidney biopsy is an informative method for diagnosing kidney pathologies, which will allow diagnosing the process with high accuracy, with a low percentage of complications.