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Introduction ⬇

A kidney biopsy is obtained to establish a diagnosis in the presence of kidney dysfunction, evaluate severity and extent of disease, guide therapy, and identify candidates for kidney transplantation.

Procedure ⬆ ⬇

  1. Obtain a specimen of kidney tissue (containing 8–10 glomeruli) by needle biopsy or open surgical technique using x-ray or ultrasound as a guide.

  2. Place in normal saline until frozen or place in a fixative or saline and send immediately to the laboratory. Check with your laboratory for specific handling instructions. Proper handling is critical to ensure that the specimen is properly preserved for necessary testing.

  3. See Fine-Needle Aspirates: Cytologic (Cell) and Histologic (Tissue) Study for information regarding obtaining kidney material for cytologic study.

Clinical Implications ⬆ ⬇

Abnormal patterns reveal interstitial fibroses and scleroses, diabetic nephrotic pathology syndrome, chronic kidney disease, kidney transplant reactions, kidney rejection or failure, past infections, glomerulonephritis, and renal pathology in systemic diseases.

Interventions ⬆ ⬇

Pretest Patient Care

  1. Explain purpose, procedure, benefits, and risks of kidney biopsy.

  2. Use sedation and local or general anesthesia if necessary.

  3. Obtain or confirm a signed, witnessed consent form.

  4. Be aware that contraindications include uncontrolled bleeding, cancer, large cysts, abscess, pregnancy, acute pyelonephritis, and aneurysm.

  5. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan as needed. Counsel the patient appropriately.

  2. Monitor for complications, which include hematuria (more common in uncontrolled hypertension and uremia), hematomas (presence of a local mass), infection, and laceration of other organs.

  3. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.

Clinical Alert

Death (although very rare) has occurred in 0.12% of patients

Reference Values ⬆

Normal

No patterns of abnormality or abnormal glomeruli

No evidence of drug toxicity, infection, or inflammation