Nephrobiopsy: an accurate diagnosis for a nephrologist
The morphological type of glomerular damage determines treatment - from observation to immunosuppressive therapy, therefore the nephrologist refers for a biopsy for proteinuria more than 1 g / day, hematuria with protein, nephrotic syndrome, and a rapid decrease in kidney function of unknown cause. The columns are taken from the cortex of the lower pole (there are enough glomeruli and few large vessels) with a 16–18 G needle under ultrasound control, at least 10–15 glomeruli in the specimen. Prerequisites: controlled blood pressure below 140/90, normal coagulation, discontinuation of antiplatelet agents. After the procedure - 6-12 hours of lying down and ultrasound the next day.
Why is a kidney biopsy necessary?
A biopsy is the only way to find out the exact nature of the changes in the kidney. In nephrology, it is performed for glomerulonephritis, nephrotic syndrome, unexplained renal failure and protein in the urine in order to select treatment according to the morphological type. In urology - for kidney tumors, when the diagnosis on CT is unclear, before ablation or active surveillance of small formations, when lymphoma or metastasis is suspected, and in patients for whom surgery is contraindicated.
Security
Under ultrasound guidance with a thin needle, the risk of complications is low: a small hematoma occurs in 5–10% and resolves on its own, significant bleeding occurs in less than 1%. For prevention, blood thinning medications are stopped a week in advance, blood pressure and coagulation are monitored, and after the biopsy the patient lies for 6-12 hours and is observed in the clinic. A control ultrasound is performed a day later.
