50200 Renal biopsy; percutaneous, by trocar or needle

Name of the Procedure:

Renal Biopsy; Percutaneous, by Trocar or Needle

• Common Name: Kidney Biopsy
• Technical Term: Renal Biopsy (Percutaneous)

Summary

A renal biopsy is a medical procedure where a small sample of kidney tissue is taken through the skin using a needle or trocar. This sample is then examined under a microscope to diagnose or monitor kidney conditions.

Purpose

• Medical Condition: Assesses kidney function and diagnoses conditions such as nephritis, nephrotic syndrome, and unexplained kidney failure.
• Goals/Outcomes: Identifies underlying kidney disease, allows for targeted treatment plans, and monitors disease progression or response to therapy.

Indications

• Persistent hematuria (blood in urine)
• Proteinuria (protein in urine)
• Unexplained chronic kidney disease or acute kidney injury
• Monitoring the progression of known kidney disease
• Assessment of a kidney transplant's health

Preparation

• Pre-procedure Instructions: Fasting for 6-8 hours prior; discontinue blood-thinning medications as directed.
• Diagnostic Tests: Blood tests to assess clotting and kidney function, imaging tests like ultrasound to visualize the kidney.

Procedure Description

1. Patient lies face down on an examination table.
2. Local anesthesia is administered to numb the area.
3. Using ultrasound or CT guidance, a needle or trocar is inserted through the skin to the kidney.
4. A small sample of kidney tissue is extracted.
5. The sample is sent to a lab for microscopic evaluation.

• Tools/Equipment: Needle, trocar, ultrasound machine, CT scanner.
• Anesthesia: Local anesthesia; mild sedation may be used in some cases.

Duration

• The procedure typically takes about 30-60 minutes.

Setting

• Usually performed in a hospital or specialized outpatient clinic.

Personnel

• Nephrologist or Interventional Radiologist
• Nurse or Medical Assistant
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common risks: Bleeding, pain at the biopsy site, infection.
• Rare complications: Arteriovenous fistula, injury to adjacent organs, needle breakage.
• Management: Close monitoring post-procedure, bed rest to minimize bleeding, antibiotics if infection occurs.

Benefits

• Provides a definitive diagnosis to guide effective treatment.
• Helps in monitoring the progression and response to treatment of kidney diseases.
• Results are typically available within a few days.

Recovery

• Post-procedure Care: Bed rest for 4-6 hours, monitoring for signs of bleeding or infection.
• Recovery Time: Generally 1-2 days for full recovery; avoid heavy lifting and strenuous activities for at least a week.
• Follow-up: Subsequent appointment to discuss biopsy results and further treatment.

Alternatives

• Imaging Tests: Ultrasound, CT scan, MRI (non-invasive but less definitive).
• Blood and Urine Tests: Can indicate kidney issues but not specific detailed information.
• Cons: Less precise in identifying specific kidney pathologies; may delay accurate diagnosis.

Patient Experience

• During the Procedure: Mild discomfort, a potential feeling of pressure when the needle is inserted.
• After the Procedure: Soreness at the biopsy site, manageable with pain relievers; possible mild hematuria.
• Pain Management: Local anesthesia during the procedure; over-the-counter pain medication post-procedure.