The word 'biopsy' almost always brings out the fear of cancer.  But the term 'biopsy' means obtaining a piece of (any) tissue and examining them under the microscope or subjecting it to any other form of analysis.   During the evaluation of kidney disease by a NEPHROLOGIST (Kidney disease specialist) kidney biopsy  is rarely performed to exclude cancer of the kidney.  Most of the time it is recommended to make appropriate diagnosis of the kidney diseases that are not cancerous.

            There are two methods of doing the kidney biopsy:

            1.   Needle Biopsy:  This is the least invasive and most preferred method.  It is usually done in the x-ray department.   Either the ultrasound equipment or the CT-Scan (CAT-Scan) is used to measure the depth and location of the kidney. Then under local anesthesia a specialized biopsy needle is inserted into the kidney from the back. A small core of the kidney tissue is obtained.  This does not involve any cutting or stitching. Essentially the needle biopsy avoids the need for open biopsy through a major surgery.

             Nevertheless, the kidney has millions of small blood vessels. Therefore, although significant hemorrhage is not common, it can occur. To avoid this complication, the following measures are taken by the Kidney Specialist who usually does the biopsy:

             a.  Since kidney diseases usually cause high blood pressure
                  (Hypertension) this will be controlled prior to biopsy.
                  Kidney biopsy in a patient with uncontrolled hypertension,
                  may increase the chances of bleeding complications.

             b.  Patients are advised not to take any blood thinners,
                  including Aspirin or Aspirin containing products and non-steroidal
                  anti-inflammatory agents,  at least for 10 days prior to the biopsy.

             c.  The clotting ability of the blood of the patient is tested
                  just prior to the biopsy. If they are not normal, biopsy will be
                  postponed until the defective clotting ability of patient's
                  blood is evaluated.

             d   After the biopsy, patient will be observed in the hospital
                  for 12 to 24 hours.  During that time he will be kept at
                  complete bed rest and will be watched for any
                  hemorrhage.

                  If the hemorrhage occurs patient might need medications
                  to stop such hemorrhage and / or blood transfusion.
                  This adverse development will prolong the hospital stay.
                 
                  On rare occasions, when the hemorrhage could not be
                  controlled,  surgery to stop the bleeding might  be
                  necessary. During surgery,  at times the entire kidney 
                  may need to be removed to control the hemorrhage.

             e.  Since hemorrhage could occur  even several days
                  after the biopsy,  patient might be advised
                  rest and home confinement for about a week 
                  following the procedure.

    2.   Open kidney biopsy through surgical procedure:
          This involves surgery under anesthesia where the kidney is exposed and
          a tiny piece of the tissue is surgically removed.  Bleeding is well
          controlled before the incision is closed with sutures. Due to the
          extent of surgery, Prolonged hospitalization to recuperate is necessary.
          Naturally, carries the risk of surgery and the anesthesia.