A kidney biopsy involves the removal of small samples of kidney tissue to help diagnose disease or damage in the organ. Biopsy results can show scarring and inflammation, as well as detect cancer in an abnormal mass.

There are several types of kidney biopsy procedures. The most common is a percutaneous biopsy. For this procedure, doctors insert a biopsy needle through the skin and into the kidney.

There are some risks associated with kidney biopsies. These may include bleeding, pain, and infection.

Keep reading to learn more about kidney biopsies, including why doctors order them, costs, preparation for one, and risks involved.

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A kidney biopsy is a procedure that removes tiny pieces of kidney tissue for experts to examine using a special microscope.

The microscope provides magnification that enables a pathologist to see details within the tissue. This may reveal signs of disease or damage. A pathologist is a scientist who examines lab samples for diagnostic purposes.

If a person’s lab tests indicate any of the following, a doctor may recommend a kidney biopsy:

A kidney biopsy can also help:

  • identify parts of the kidney that are damaged and predict the likelihood of the damage worsening
  • check for signs of scarring, infection, inflammation, or unusual quantities of a protein called immunoglobulin
  • decide the best treatment option for a kidney problem
  • examine an abnormal lump or mass in more detail after X-ray or ultrasound detection
  • find the reason for dysfunction in a transplanted kidney

As well as helping diagnose the nature and extent of a kidney problem, a biopsy can also provide valuable information on how a person is responding to a treatment regimen.

A 2016 study compared the costs of hospital-based percutaneous kidney biopsies with those of office-based ones.

Among 78 people, hospital facility costs ranged from $3,280–3,449, while office facility costs were $1,056.

Total costs, which include the facility, pathologist, and professional fees, ranged from $4,470–4,598 for hospital-based biopsies. Office-based costs were $2,129.

It is important to emphasize that the above costs are for percutaneous biopsies, which are the biopsies performed most often. Because the less common types of biopsies require more medical care and services, the costs of those may be higher.

Before a biopsy, a person should tell their doctor all the medications and dietary supplements they take.

Certain drugs can increase a person’s risk of bleeding and affect their response to the anesthesia used in some procedures. Medications that can pose a problem include:

Individuals should also tell their doctor about any allergies they have.

High blood pressure can raise the risk of bleeding. If someone has this condition, they should inform their doctor.

To prepare for the procedure, people should follow their doctor’s instructions for:

  • discontinuing medications
  • fasting
  • undergoing blood tests and imaging tests such as ultrasound and CT scans
  • making arrangements for a ride home
  • arriving 90 minutes to 2 hours before the procedure to sign consent forms and have tests

There are several types of kidney biopsies. The procedure differs depending on the type:

Percutaneous kidney biopsy

The healthcare professional inserts a biopsy needle through the skin and into the kidneys. It typically takes about 1 hour.

  1. The person will typically lie face-down. However, certain people may undergo the biopsy in a seated or other position.
  2. A healthcare professional administers a sedative through an intravenous line in a vein. This helps promote relaxation.
  3. The healthcare professional also injects a local anesthetic to numb the site. A local anesthetic only affects the area involved in the biopsy rather than the entire body.
  4. Using imaging methods, the healthcare professional guides the biopsy needle to the appropriate area. If more than one sample is necessary, this may happen several times.
  5. The healthcare professional uses the needle to take samples.
  6. Following the biopsy, the healthcare professional places a bandage over the area the needle entered.

Laparoscopic kidney biopsy

For this procedure, a healthcare professional administers general anesthesia, which puts a person in a sleep-like state. Then, they make two small cuts in the back and insert tools to obtain the kidney samples.

Transjugular kidney biopsy

This procedure is less common than laparoscopic biopsy. A healthcare professional inserts a needle and catheter into a vein in the neck. Next, they guide the needle through the vein to the kidney to obtain a sample.

Open kidney biopsy

Having an open kidney biopsy is rare.

First, a healthcare professional administers general anesthesia. Then, they make a small cut in the skin, remove a small sample, and stitch the cut closed.

Immediately following the biopsy procedure, the healthcare professional may:

The person can eventually go home to rest, though in some cases, an overnight stay may be necessary.

People can expect the following:

  • pain and soreness at the biopsy site
  • urine appearing slightly cloudy or pink for 24–48 hours
  • instruction to avoid contact sports, heavy lifting, and strenuous exercise for 2 weeks

Seeking urgent care

Following the biopsy, a person should seek immediate medical attention if they experience:

The wait time for biopsy results may be a few days or longer. A doctor will explain the results in a follow-up visit. The results may be able to determine the cause of kidney damage or how well a person is responding to treatment, among other things.

Sometimes, the biopsy may reveal atypical results. These may indicate:

Complications occur in 1% or fewer of people who undergo a kidney biopsy. Risks include:

  • pain and bruising
  • damage to nearby organs
  • bleeding inside the body or at the biopsy site
  • infection

Doctors typically perform a kidney biopsy when a person’s lab tests indicate they have abnormal levels of protein or persistent blood in the urine. They may also order a biopsy if a person has a kidney malfunction that causes a buildup of waste in the blood.

In the most common type of biopsy (percutaneous), a person lies on their stomach and receives a sedative and local anesthetic. Next, a healthcare professional uses an ultrasound to guide a biopsy needle into the kidney to obtain the sample.

Complications are not common, though they can happen. A person should report any symptoms that occur afterward to a doctor, such as fever or the inability to urinate.