Kidney biopsy

A kidney biopsy helps to assess and diagnose if you have a kidney problem. Kidney biopsies are usually done for one of three reasons:

• To find out why a kidney is not working properly.
• To get a tissue sample when there is a growth (mass) on a kidney.
• To assess a kidney before a kidney transplant.

A biopsy is important to help make a diagnosis and plan any treatment.

There is no other test that will give your doctor the same information as a kidney biopsy.

• Some people will feel pain. This is usually not severe and can be helped with simple painkillers
• Bleeding or bruising where the needle goes in. This should settle down by itself.
• There is a risk of minor internal bleeding after the biopsy. The risk is around 1 in 20 and will usually settle down by itself. A nurse will monitor your blood pressure and pulse during and after the biopsy. You will stay in hospital for up to five hours afterwards so that we can monitor you.
• Some people will notice blood in their urine after a biopsy. This will usually settle on its own within a few days. If this continues for more than one week, or if you pass a lot of blood, contact the Imaging department. The number for the Imaging department is on your appointment letter.
• If you become unwell outside of working hours (Monday - Friday, 08:00 - 17:00), go to the Emergency Department (ED).
• Sometimes people will have more serious internal bleeding. In this case it may be necessary to do a further procedure to try to stop the bleeding. This will happen in approximately 1 in 50 people.
• There is a very small risk of death. This risk is less than 1 in 1000.

You will need to have a blood test a few days before the biopsy to check that you are not at a higher risk of bleeding. This will happen at your GP surgery.

You can carry on taking your normal medicines.

If you are on any medicine that thins the blood you should call the Imaging department using the number on your appointment letter. We may need to adjust your medicines before having this procedure. This is to keep the risk of bleeding as low as possible. Blood thinning medicines include aspirin, clopidogrel, warfarin, rivaroxaban, dabigatran and apixaban. Please note this is not all blood thinning medicines.

Please arrange for someone to collect you from the hospital and take you home by car. We advise you not to use public transport. You are not allowed to drive for 24 hours after the biopsy and we would like someone to stay with you at home for the first 24 hours. Please phone the Imaging department a few days before your appointment if this is not possible.

• Do not eat for 6 hours before your appointment.
• You may carry on drinking water.
• You will arrive at Gate 19 and be brought into our day case area.
• Please bring a list of your usual medicines.
• Please let us know if you are allergic to anything.
• You will change into a hospital gown and a small plastic tube (cannula) may be put into your arm.
• A radiologist (X-ray doctor) will discuss the biopsy with you. You may ask any questions you have. If you are happy to go ahead with the biopsy you will be asked to sign a consent form.
• Once all the checks have been done, you will be taken to the procedure room on the trolley. There will be a nurse and a radiologist with you during the procedure.
• The radiologist will use an ultrasound machine to look at your kidney to find the correct area to take the biopsy from.
• Your skin will be cleaned with a cleaning solution and covered with sterile drapes.
• The radiologist will inject a numbing medicine into the skin, which will briefly sting and then go numb. Most people will feel a pushing sensation, but the biopsy is not usually painful.
• A special needle is used to remove a small piece of kidney tissue. Occasionally more than one sample is needed.
• When the radiologist has enough sample(s), they will remove the needle and put a plaster on your skin.

• You will go back to the day case area so that the nursing staff may monitor you closely.
• If you are in pain tell the nursing staff so you can be given painkillers.
• You will need to stay lying flat for one hour and then sit up for a further two hours.
• You will be able to eat and drink as normal.
• Once you are feeling ok you will be free to go home. Please arrange for someone to collect you when you are discharged rather than drive yourself.
• Have someone stay with you overnight.
• You should rest for the remainder of that day and the following day. Avoid strenuous activities for 36 hours.
• Keep a regular check on the biopsy site. The dressing can be removed after 24 hours.
• If you have any discomfort, take your usual pain relief as prescribed. But, if the pain is severe please contact the Imaging department using the number on your appointment letter.
• Some people pass blood in their urine after a biopsy.
• This will usually settle on its own within a few days. If you continue to pass blood for more than one week or if you pass a lot of blood, contact the Imaging department. If you become unwell out of working hours, go to the Emergency Department.

The results of the biopsy will be sent to the doctor who asked for the biopsy to be done. They will contact you or write to your GP with the results.

If you have any symptoms you are concerned about, contact the Imaging department on the number on your appointment letter. You can also contact your GP or the Emergency Department.

North Bristol NHS Trust (2022) “Ultrasound Guided Liver Biopsy” 

North Bristol NHS Trust (2022) “Kidney Biopsy Information for Patients” 

Halimi, J., Gatault, P., Louguet, H., Barbet, C., Bisson, A., Sautenet, B., Herbert, J., Buchler, M., Grammatico-Guillon, L. & Fauchier, L. Clinical Journal of the American Society of Nephrology (2020) “Major Bleeding and Risk of Death after Percutaneous Native Kidney Biopsies”