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Kidney Biopsy in Children

Kidney Biopsy in Children - What is it for

Renal biopsy is a procedure whereby a special needle is passed through the skin near the loin area at the back to obtain tiny pieces of kidney tissue for specialised studies. 

The needle can be visualised as it is passed into the body to the kidney (usually the lower end of the left kidney) using an ultrasound machine. Its passage is fully guided by real-time imagines reflected on the screen. It is thus a safe procedure and complications are very rare. 

Why is renal biopsy important in the treatment of kidney disease?
The renal tissues obtained from the biopsy are examined under microscope including sometimes electron microscope which is a very powerful microscope that can reveal the ultra-structures of the kidney. Special staining of the tissues is also done to further study any abnormalities. All these specialised examinations or what we term “histopathology” will help us to pinpoint and diagnose accurately the various underlying kidney diseases so that we can accurately formulate treatment plan. 

When is renal biopsy indicated?
There are clear indications for doing a renal biopsy. It is generally done to diagnose accurately kidney diseases that can progress to kidney damage where aggressive treatment is necessary. The doctor will need to discuss in detail the indications for renal biopsy. 

Kidney Biopsy in Children - Symptoms

Kidney Biopsy in Children - How to prevent?

Kidney Biopsy in Children - Causes and Risk Factors

What are the contraindications and complications of renal biopsy?
The main complication of renal biopsy is bleeding. If there is any blood coagulation problem, renal biopsy cannot be safely done as there may be uncontrolled bleeding. It is therefore mandatory that patient’s coagulation profile be checked by various blood tests before renal biopsy. 

Conditions that can cause bleeding tendencies are certain blood disease, the consumptions of drugs like Aspirin or other non-steroidal anti-inflammatory drugs, which must be stopped at least five days prior to renal biopsy. 

Other contraindications of renal biopsy include severe or uncontrolled hypertension, anaemia, single kidney and cystic kidneys. 

While blood-stained urine is a very common occurrence after renal biopsy, it should clear up within one day. The presence of blood clots or heavily blood-stained urine may signify more severe bleeding that required immediate attention. Occasionally, transient fever is observed after biopsy. 

Kidney Biopsy in Children - Diagnosis

Kidney Biopsy in Children - Treatments

How is renal biopsy done?
The procedure is done with patient sedated under monitoring. Biopsy is done through a 2 to 3mm skin incision at the back over the loin area. A specialised needle is introduced under ultrasound guidance, directed at the lower end of the kidney where two to three tiny bites of renal tissues were taken. The renal tissues obtained are then prepared and sent for histological studies. The whole procedure usually takes about 20 to 30 minutes and patient usually awakes soon after the procedure. 

Kidney Biopsy in Children - Preparing for surgery

Kidney Biopsy in Children - Post-surgery care

What to expect after renal biopsy is done?
Normal eating and drinking can be resumed when the patient is awake. Rest by lying flat on the back to press on the wound site to stop bleeding if any. The patient will be monitored overnight for any signs of bleeding. The patient will be reviewed and discharged the next day. Refrain from physical exercise for up to six months. The discharge advice includes returning to hospital if there is heavily blood-stained urine especially in the presence of blood clots, pain over biopsy site, fever, abdominal pain and vomiting. 

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