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Renal biopsy; percutaneous, by trocar or needle
CPT4 code
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
- Patient lies face down on an examination table.
- Local anesthesia is administered to numb the area.
- Using ultrasound or CT guidance, a needle or trocar is inserted through the skin to the kidney.
- A small sample of kidney tissue is extracted.
- 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.