19Feb

Kidney biopsy: indications, contraindications, complications

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Most often, a kidney biopsy is performed with a pronounced nephrotic syndrome or acute attack of kidney failure, lasting for several days and not detectable by standard methods. After carrying out the procedure of kidney biopsy, the material for research is sent to the laboratory, which will help to diagnose with the highest degree of probability.

Procedure for kidney biopsy - what is it?

In modern nephrology, in addition to simple and well-known methods of diagnosis, such as, for example, a general urine test, a blood test for creatinine and urea, etc., there are very complex methods. Their complexity consists, in one case, in high technicality and cost of a technique, in another - in necessity of a selection of a tissue of a kidney for research. The last study is called a kidney biopsy.

What is a kidney biopsy, and how is this procedure performed? The word "biopsy" is of Greek origin and means a microscopic examination of tissues and organs that were otherwise excised or otherwise seized with a diagnostic purpose.

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During the biopsy, the doctor takes one or more small pieces of kidney tissue( usually the piece has the shape of a string of 5-10 mm long and about 1 mm thick).This biological material is placed in a special solution and delivered to the pathomorphological laboratory, where the laboratory worker produces it and the pathologist prepares the micropreparation. Then the micropreparation is examined under a microscope. The study of a biopsy is a great help for a doctor, which often allows a correct diagnosis. A correct diagnosis is the most important condition for effective treatment.

In some cases, the patient's refusal to perform a biopsy becomes fatal in his fate.

Kidney tissue is removed by a special needle. Typically, the procedure takes about 10 minutes in time-this is the time taken to process the surgical field( the skin of the lumbar region at the place where the puncture will be made), the anesthesia of the skin, subcutaneous tissue and muscles at the puncture site, as well as the puncture and the application of a sterile bandageon the postoperative field.

Preparing for kidney biopsy and performing the procedure

Now, in order, as kidney biopsy is done, and how long this procedure takes.

In preparation for a kidney biopsy, the treatment of the operating field is performed by special solutions of substances that kill microorganisms. They are called antiseptics. This is done so that at the time of biopsy, microorganisms can not be introduced into the patient's body and the development of the inflammatory process can be avoided. Anesthesia of the skin, subcutaneous tissue and muscles is done with the help of anesthetics( anesthetic substances), most often used for this purpose are solutions of novocaine, lidocaine.

Adequate anesthesia makes the biopsy procedure overwhelmingly painless.

With what can you compare those discomforts that occur with a biopsy? Most of the patients compare them to the discomfort that occurs with intramuscular or intravenous injection. Very rarely a patient compares a biopsy with a visit to the dentist. After anesthesia, a special needle is inserted deep into the tissues and brought to the kidney capsule.

Do you think how the doctor will locate the needle in the tissues and can he pierce a large vessel or other organ? Such complications are extremely rare. After all, when carrying out a biopsy a doctor has a true friend - an ultrasound machine. With the help of this device, he sees the kidney on the screen and sees the needle, the introduction of the needle into the tissue is clearly controlled by means of an ultrasound machine.

Watch the video "Kidney biopsy" to better understand how this procedure is performed:

Biopsy and possible complications after

are dangerous. After the biopsy is performed, the patient's kidneys on a gurney are delivered to the ward and bed rest is recommended for at least 24 hours. After about 12 hours, he can get out of bed for a few minutes in order to produce urination. It is advisable to drink a cup of warm tea 30 minutes prior to biopsy. This is done in order to get the first portion of urine from the patient within 30-60 minutes. Her visual assessment will allow the doctor to identify a possible menacing complication of the kidney biopsy - kidney bleeding.

The fact is that everything that is used in medicine as a medicine or diagnostic device, carries a certain risk to the health and life of the patient. Ancient thinker and doctor Paracelsus also said: "Everything is poison, and nothing is poisonous, only the dose and concentration make the poison invisible."A biopsy in the hands of an amateur can become dangerous for the patient. Fortunately, the biopsy is performed by highly qualified nephrologists and urologists. The usefulness of the kidney biopsy is immeasurable, with the harm that it can bring to the patient.

Is kidney biopsy dangerous and how often do biopsy complications occur?

According to the world literature, the death of a patient after a kidney biopsy occurs in 0.01% of cases. The main cause of death is renal bleeding. In general, after a biopsy, renal bleeding is recorded in 5% of patients. Almost all patients have an increased amount of erythrocytes in the urine detected by microscopy and is a common occurrence accompanying this procedure.

When there are signs of bleeding, the patient is injected with hemostatic drugs and must be examined by a urologist who specializes in the pathology of the urinary system.

Indications and contraindications for kidney biopsy

In order for you to objectively assess the need for biopsy, read the main indications for it:

  • the presence of a nephrotic syndrome;
  • is also an indication for kidney biopsy is the presence of nephritic syndrome with the exclusion of the kidney defect, urinary tract tumor, urolithiasis, i.e., causes changes in urine tests;
  • acute renal failure of unknown origin, which is not allowed for several days.

There are contraindications to kidney biopsy, which include:

  • the presence of one kidney;
  • coagulation disorder;
  • marked chronic renal failure;
  • shock, coma, agony;
  • severe anemia( anemia);
  • cysts of both kidneys;
  • kidney tuberculosis.

But, perhaps, the most important contraindication for the biopsy is the patient's disagreement on the procedure!

The overwhelming majority of patients successfully transfer a biopsy, on the skin of the lumbar region there is a small whitish scar 2-4 mm in size, reminiscent of a biopsy.

Where is it better to do a kidney biopsy to be confident in the professionalism of doctors? Currently, kidney biopsy is conducted in large interregional centers. In particular, in the South of Russia such a center is located in the clinic of the Rostov State Medical University. In interregional centers databases on kidney biopsies are formed, the incidence of certain forms of nephritis is analyzed, which makes it possible to formulate approaches to the most qualitative treatment of patients.