{"id":21390,"date":"2017-06-22T12:32:39","date_gmt":"2017-06-22T16:32:39","guid":{"rendered":"http:\/\/www.stepwards.com\/?page_id=21390"},"modified":"2025-03-21T23:45:44","modified_gmt":"2025-03-22T03:45:44","slug":"interventional-radiology-procedures-renal-biopsy","status":"publish","type":"page","link":"https:\/\/www.stepwards.com\/?page_id=21390","title":{"rendered":"Interventional Radiology Procedures: Ultrasound Guided Non-Focal Renal Biopsy"},"content":{"rendered":"<div id=\"toc_container\" class=\"no_bullets\"><p class=\"toc_title\">Page Contents<\/p><ul class=\"toc_list\"><li><a href=\"#OVERVIEW\"><span class=\"toc_number toc_depth_1\">1<\/span> OVERVIEW<\/a><\/li><li><a href=\"#IMPORTANT_CONSIDERATIONS_BEFORE_BEGINNING_THE_PROCEDURE\"><span class=\"toc_number toc_depth_1\">2<\/span> IMPORTANT CONSIDERATIONS BEFORE BEGINNING THE PROCEDURE<\/a><\/li><li><a href=\"#STEP_1_POSITIONING_THE_PATIENT\"><span class=\"toc_number toc_depth_1\">3<\/span> STEP 1: POSITIONING THE PATIENT<\/a><\/li><li><a href=\"#STEP_2_PERFORMING_THE_BIOPSY\"><span class=\"toc_number toc_depth_1\">4<\/span> STEP 2: PERFORMING THE BIOPSY<\/a><\/li><li><a href=\"#STEP_3_EVALUATING_FOR_POST-PROCEDURAL_BLEEDING\"><span class=\"toc_number toc_depth_1\">5<\/span> STEP 3: EVALUATING FOR POST-PROCEDURAL BLEEDING<\/a><\/li><\/ul><\/div>\n<h5><span id=\"OVERVIEW\"><span style=\"text-decoration: underline;\">OVERVIEW<\/span><\/span><\/h5>\n<p>This page is dedicated to describing how to conduct an\u00a0<strong>ultrasound guided\u00a0non-focal renal biopsy.\u00a0<\/strong>This is a procedure that is commonly conducted in the field of interventional radiology in order to collect tissue from the kidneys (which can be used diagnostically).<\/p>\n<h5><span id=\"IMPORTANT_CONSIDERATIONS_BEFORE_BEGINNING_THE_PROCEDURE\"><span style=\"text-decoration: underline;\">IMPORTANT CONSIDERATIONS BEFORE BEGINNING THE PROCEDURE<\/span><\/span><\/h5>\n<p><span style=\"text-decoration: underline;\"><strong>As is the case with many procedures, there can be\u00a0contraindications that should be evaluated for before beginning.<\/strong><\/span>\u00a0While the evidence base in some cases in anecdotal\/limited, there are a few clinical contexts under which a renal biopsy should <strong>NOT<\/strong> be performed due to the increased risk of complications (read more on this topic <a href=\"http:\/\/www.stepwards.com\/?page_id=21387\">here<\/a>):<\/p>\n<ul>\n<li><strong>High blood pressure (systolic blood pressure &lt;160 mm Hg)<\/strong><\/li>\n<li><strong>Hydronephrosis (signs present on imaging)<\/strong><\/li>\n<li><strong>Elevated INR (&gt;1.5)<\/strong><\/li>\n<li><strong>Low platelets (&lt;\u00a050 x 10\u00b3\/\u00b5l of blood)<\/strong><\/li>\n<li><strong>Low hemoglobin (anemia):<\/strong> a Hg of below 9.0 mg\/dLis a risk factor for serious\u00a0complications after a kidney biopsy.<\/li>\n<li><strong>Recent usage of &#8220;blood thinning&#8221; medications:\u00a0<\/strong>Special attention should be paid to the usage of medications such as warfarin, aspirin or NSAIDs (usage of any of these medications within 7 days of the biopsy is associated with a serious bleed due to the procedure).<\/li>\n<\/ul>\n<h5><span id=\"STEP_1_POSITIONING_THE_PATIENT\"><span style=\"text-decoration: underline;\">STEP 1: POSITIONING THE PATIENT<\/span><\/span><\/h5>\n<p>Provided that there are no contradictions, after informed consent is obtained from the patient, they can be positioned in the supine position and the kidney(s) can be scanned with an ultrasound to assess for the best access for the biopsy (typically from the posterior flank). Once a site is picked, the access point can be prepped in a sterile fashion (cleaned and draped in a sterile fashion) and intravenous conscious sedation can be given.<\/p>\n<figure id=\"attachment_21432\" aria-describedby=\"caption-attachment-21432\" style=\"width: 684px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2.png\"><img loading=\"lazy\" class=\" wp-image-21432\" src=\"http:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2.png\" alt=\"\" width=\"694\" height=\"572\" srcset=\"https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2.png 1031w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-300x247.png 300w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-768x633.png 768w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-1024x844.png 1024w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-100x82.png 100w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-150x124.png 150w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-200x165.png 200w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-450x371.png 450w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-600x495.png 600w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/2-900x742.png 900w\" sizes=\"(max-width: 694px) 100vw, 694px\" \/><\/a><figcaption id=\"caption-attachment-21432\" class=\"wp-caption-text\">Left renal ultrasound that demonstrating an unremarkable appearing kidney. This was conducted prior to a renal biopsy in order to determine the best access point for the procedure, while assessing for hydronephrosis (a contraindication for the planned procedure).<\/figcaption><\/figure>\n<h5><span id=\"STEP_2_PERFORMING_THE_BIOPSY\"><span style=\"text-decoration: underline;\">STEP 2: PERFORMING THE BIOPSY<\/span><\/span><\/h5>\n<p>Once the access point is picked, and the patient is prepped 1% lidocaine can be used to numb the skin and subcutaneous tissues (in the path that will be used to access the kidneys). After waiting a minute for the local anesthesia to take effect, \u00a0the biopsy needle can be introduced (under the guidance of ultrasound) through the retroperitoneal space into the renal cortex. Core biopsy samples can be obtained and sent for analysis.<\/p>\n<figure id=\"attachment_21434\" aria-describedby=\"caption-attachment-21434\" style=\"width: 727px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3.png\"><img loading=\"lazy\" class=\" wp-image-21434\" src=\"http:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3.png\" alt=\"\" width=\"737\" height=\"623\" srcset=\"https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3.png 1023w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3-300x253.png 300w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3-768x649.png 768w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3-100x84.png 100w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3-150x127.png 150w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3-200x169.png 200w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3-450x380.png 450w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3-600x507.png 600w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/3-900x760.png 900w\" sizes=\"(max-width: 737px) 100vw, 737px\" \/><\/a><figcaption id=\"caption-attachment-21434\" class=\"wp-caption-text\">Renal ultrasound of the left kidney during a non-focal biopsy. The echogenic biopsy needle can be seen with its tip in the renal cortex where the core biopsies are taken.<\/figcaption><\/figure>\n<h5><span id=\"STEP_3_EVALUATING_FOR_POST-PROCEDURAL_BLEEDING\"><span style=\"text-decoration: underline;\">STEP 3: EVALUATING FOR POST-PROCEDURAL BLEEDING<\/span><\/span><\/h5>\n<p>Due to the risk of bleeding during a renal biopsy, after the procedure the kidney\/its surrounding should be evaluated with the ultrasound probe again to assess for any signs of bleeding. Provided that no signs of bleeding are present, the patient&#8217;s access point can be dressed with a bandage and they can be sent on their way.<\/p>\n<figure id=\"attachment_21436\" aria-describedby=\"caption-attachment-21436\" style=\"width: 786px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1.png\"><img loading=\"lazy\" class=\" wp-image-21436\" src=\"http:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1.png\" alt=\"\" width=\"796\" height=\"648\" srcset=\"https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1.png 1050w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-300x244.png 300w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-768x625.png 768w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-1024x834.png 1024w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-100x81.png 100w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-150x122.png 150w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-200x163.png 200w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-450x366.png 450w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-600x489.png 600w, https:\/\/www.stepwards.com\/wp-content\/uploads\/2017\/06\/6-1-900x733.png 900w\" sizes=\"(max-width: 796px) 100vw, 796px\" \/><\/a><figcaption id=\"caption-attachment-21436\" class=\"wp-caption-text\">Post-procedural ultrasound of the left kidney following a non-focal renal biopsy. No signs of bleeding are seen.<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<pre><span style=\"font-family: Consolas, Monaco, monospace; font-size: 16px;\">Page Updated: 06.28.2017<\/span><\/pre>\n","protected":false},"excerpt":{"rendered":"<p>Page Contents1 OVERVIEW2 IMPORTANT CONSIDERATIONS BEFORE BEGINNING THE PROCEDURE3 STEP 1: POSITIONING THE PATIENT4 STEP 2: PERFORMING THE BIOPSY5 STEP 3: EVALUATING FOR POST-PROCEDURAL BLEEDING OVERVIEW This page is dedicated to describing how to conduct an\u00a0ultrasound guided\u00a0non-focal renal biopsy.\u00a0This is a procedure that is commonly conducted in the field of interventional radiology in order to &#8230; <a title=\"Interventional Radiology Procedures: Ultrasound Guided Non-Focal Renal Biopsy\" class=\"read-more\" href=\"https:\/\/www.stepwards.com\/?page_id=21390\" aria-label=\"More on Interventional Radiology Procedures: Ultrasound Guided Non-Focal Renal Biopsy\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":21302,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_mi_skip_tracking":false},"jetpack_shortlink":"https:\/\/wp.me\/P71awf-5z0","_links":{"self":[{"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages\/21390"}],"collection":[{"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21390"}],"version-history":[{"count":2,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages\/21390\/revisions"}],"predecessor-version":[{"id":28758,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages\/21390\/revisions\/28758"}],"up":[{"embeddable":true,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages\/21302"}],"wp:attachment":[{"href":"https:\/\/www.stepwards.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21390"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}