What is a kidney biopsy?
It is a procedure to obtain a very tiny piece from the kidney to observe under microscope. A kidney biopsy is performed to diagnose kidney disease in your child, when blood, urine tests and radiological investigations do not give enough information about the underlying disease. Most of the diseases affect both kidneys, so tissue needs to be obtained only from one kidney.
What are the indications of Kidney biopsy in children?
Need for renal biopsy will be determined by your doctor by carefully reviewing the clinical profile, blood and urine tests. Following are the indications:
- Nephrotic syndrome not responding to steroids, i.e. steroid resistance
- When secondary cause for nephrotic syndrome is suspected based on blood and urine tests or nephritic syndrome
- Recurrent unexplained hematuria with or without proteinuria
- Unexplained deterioration in renal functions
- Certain familial or inherited renal disorders
What preparation is required before kidney biopsy?
Some routine blood tests are done to check your child’s hemoglobin, platelet count and coagulation parameters before doing renal biopsy. Child is admitted to the hospital early morning or a day prior and examined to ensure fitness for kidney biopsy. As sedation is required for the procedure, your child would need to be kept without food and water for 6 hours before the biopsy. IV fluids may be started in small children.
What is the procedure for kidney biopsy?
Biopsy is done in Pediatric Intensive Care Unit (PICU) as a bedside procedure. It is not a surgery. Child is positioned and is sedation given. Under Ultrasound guidance tissue is obtained from kidney with a special needle. No stitches are required. Child’s breathing, heart rate, oxygenation and blood pressure are carefully monitored during and after the procedure. Oral intake is allowed after recovery from sedation.
What care is needed after biopsy?
Child is allowed orally, but needs to be in bed for 6 hours, as advised by the doctors.
Urine color is monitored for hematuria.
Paracetamol may be used for pain at biopsy site.
If there are no complications child is discharged the next morning. Child can return to school after 48 hours of biopsy. Active sports are to be avoided for one week.
Basic results of kidney biopsy are available in 7-10 days. Some detailed reports may take longer. Your doctor will discuss the results and treatment plan with you.