By Dr. Vinod Kumar K, Lead Senior Consultant and Transplant Physician – Nephrology, Manipal Hospital, Kanakapura Road

What Is a Kidney Biopsy?

A kidney biopsy (also called a renal biopsy) is a procedure in which a small sample of kidney tissue is collected using a special needle. The sample is then examined under a microscope to identify the type, extent, and cause of kidney disease. This helps in making an accurate diagnosis, assessing disease severity, evaluating treatment response, and monitoring transplant health.

When Is a Kidney Biopsy Recommended?

A kidney biopsy is not needed for every kidney problem. However, it becomes essential when clinical findings are unclear or when precise diagnosis influences treatment.

Common indications include:
– Unexplained proteinuria (protein in urine)
– Hematuria (blood in urine)
– Nephrotic or nephritic syndrome
– Unexplained acute kidney injury (AKI) or chronic kidney disease (CKD)
– Monitoring the course of glomerulonephritis, lupus nephritis, or diabetic nephropathy
– Kidney transplant evaluation: Suspected rejection or drug toxicity

When Should a Kidney Biopsy Be Avoided?

While kidney biopsy is generally safe, certain conditions make the procedure risky:

Absolute contraindications:
– Bleeding disorders
– Uncontrolled severe hypertension
– Active infections
– Ongoing use of blood-thinning medications
– Presence of a single functioning kidney

Relative contraindications:
– Morbid obesity
– Pregnancy
– Advanced irreversible kidney damage

How Is a Kidney Biopsy Performed?

The procedure is straightforward and typically takes 15–30 minutes:

1. Preparation:
– Routine blood tests (including clotting profile)
– Stopping anticoagulants (if applicable)

2. During the Procedure:
– Performed under local anesthesia
– Ultrasound is used to visualize the kidney
– A thin biopsy needle is inserted through the skin to collect the sample
– Usually done while lying on the stomach (for native kidney biopsy)

3. Post-Procedure Care:
– Observation for 6–24 hours to monitor for bleeding
– Vital signs and urine checked regularly
– Advised to rest and avoid heavy activity for 1–2 weeks

Risks and Safety Considerations

Most patients tolerate the procedure well. However, as with any medical intervention, there are potential risks:

Common risks:
– Mild bleeding or bruising at the biopsy site
– Temporary flank pain
– Blood in urine (usually resolves in 24–48 hours)

Rare but serious risks:
– Significant bleeding requiring transfusion
– Infection
– Injury to nearby organs
– Loss of kidney function (very rare)

Safety is ensured through:
– Careful patient selection
– Use of imaging guidance
– Experienced hands performing the biopsy
– Close post-procedure monitoring

Final Thoughts

A kidney biopsy is a vital diagnostic tool that provides valuable insights into kidney diseases that cannot be determined by blood or urine tests alone. It helps guide precise and effective treatment, improves long-term outcomes, and is especially crucial in managing complex kidney conditions and transplant care.

If your doctor recommends a biopsy, don’t panic. With modern techniques, it’s a safe and minimally invasive procedure performed under expert supervision.

Dr. Vinod Kumar K
Lead Senior Consultant – Nephrology
Manipal Hospital, Kanakapura Road

Have questions about your kidney health? Schedule a consultation and take a proactive step toward better kidney care.