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Kidney Renoscopy and Biopsy

  • Posted on- Apr 16, 2018
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What is a renal biopsy?

A renal biopsy is a medical process used to remove kidney tissue for laboratory analysis. The word “renal” describes the kidneys. A renal biopsy is also called a kidney biopsy.

The test helps the doctor to identify the type of kidney disease the patient has, how severe it is and the best treatment for it. A renal biopsy can also be used to monitor the effectiveness of kidney treatments and see if there are any complications following a kidney transplant.

There are two different ways to perform a renal biopsy. The most common type of renal biopsy is called a percutaneous biopsy, or a renal needle biopsy.

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For this procedure, a doctor inserts a thin biopsy needle through the skin to remove the patient’s kidney tissue. The doctor may use an ultrasound or CT scan to direct the needle to a specific area of the kidney.

In an open biopsy or surgical biopsy, the doctor makes a cut in the skin near the kidneys. This allows the physician to look at the kidneys and determine from which area the tissue samples should be taken.

Purpose of renal biopsy

A renal biopsy can identify what is interfering with the patient’s normal kidney function. Healthy individuals have two kidneys that perform many functions. It is the kidneys’ job to:

  • remove urea, or liquid waste, from the blood by producing urine
  • maintain a balance of chemicals, such as sodium and potassium, in the blood
  • supply the hormone erythropoietin, which supports red blood cell growth
  • control blood pressure by producing the hormone renin
  • help activate the hormone calcitriol, which regulates calcium absorption and calcium blood levels

If routine blood and urine tests indicate that the patient’s kidneys are not doing their job properly, the doctor may decide to perform a renal biopsy. The doctor might also order this test to:

  • find the reason for an abnormal level of waste products in the blood
  • see if a kidney tumor is malignant or benign
  • gauge how well a transplanted kidney is working
  • investigate the cause of hematuria, or blood in your urine
  • determine the cause of proteinuria or a high level of protein in your urine
  • see the severity of progressive kidney failure and how quickly the kidneys are failing
  • create a treatment plan for a diseased kidney


Renal biopsy procedure

A renal biopsy usually is performed as an outpatient procedure at a hospital. However, it can also be done in a radiology department if an ultrasound or CT scan is necessary during the procedure.

A percutaneous biopsy is the most common type of renal biopsy. A doctor inserts a thin biopsy needle through the skin to remove your kidney tissue.

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In an open biopsy or surgical biopsy, the doctor makes a cut in the skin near the kidneys to determine from which area to take the tissue samples.

Percutaneous biopsies

Typically, a percutaneous, or renal needle, a biopsy is done by a doctor and takes about an hour.

Just before the procedure, the doctor might give the patient a sedative through an intravenous (IV) line in his hand or arm to help him relax. However, the patient will not receive general anesthesia for this procedure, meaning that he will be awake throughout.

The patient will be positioned so that he is lying on his stomach. This will keep the patient’s kidneys easily accessible from his back.

The patient may be given a pillow or towel since he will have to remain still and stay in this position for about 30 minutes. If the patient already had a kidney transplant, he will be told to lie on his back.

Next, a doctor will inject a local anesthesia into the entry site to numb the area and make a small incision there. They will insert the needle through the incision and into the patient’s kidney. The doctor might use an ultrasound or a CT scan to direct the needle.

If more than one tissue sample is needed, the process will be repeated several times. Each time, the needle will be inserted through the same incision.

Types of percutaneous biopsies

There are actually two types of percutaneous biopsies. The type of procedure the doctor uses will determine the instrument required to remove the tissue.

In a fine needle aspiration biopsy, the doctor extracts a small tissue sample from the patient’s kidney using a small, thin needle that is attached to a syringe.

For larger tissue samples, the physician may use a needle core biopsy. In this procedure, the doctor removes a larger sample of kidney tissue using a spring-loaded needle.

If the patient is having a needle core biopsy, he will hear a loud clicking or popping sound when the tissue sample is being removed.

After the sample is retrieved, the pressure will be applied to the biopsy site until any bleeding has stopped, and a bandage will be applied over the incision site.

Open biopsies

Depending on the patient’s physical condition and medical history, the doctor may recommend an open biopsy. Usually, the patient will have this type of biopsy if he had problems with bleeding or blood clotting in the past, or if he has only one kidney.

If the patient is having an open biopsy, he will receive general anesthesia. This means that the patient will be asleep throughout the procedure. The doctor will make an incision and surgically remove a tissue sample from the kidneys while he is unconscious.

Some surgical biopsies require an incision up to five inches long. This procedure can also be performed laparoscopically. For this procedure, the doctor will make a small incision and use a laparoscope, which is a thin, lighted tube, to perform the biopsy.

The laparoscope has a video camera at the end, which sends images of the kidney to a video monitor. Using a laparoscope, the physician can observe the kidney and extract the larger tissue sample through a smaller incision.

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