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Technique

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Preparation:

  • obtain patient's informed consent
  • check full blood count, urea and electrolytes, creatinine, liver function tests, clotting profile
  • group and save serum for later blood crossmatching
  • intravenous access for infusion
  • assess size and symmetry of kidneys by ultrasound
  • other specialist investigations as required, for example, anti-glomerular basement membrane antibodies
  • pre-medication as appropriate
  • blood pressure should be less than 90 mm Hg diastolic
  • give desamino-D-arginine vasopression if creatinine level exceeds 400 micromoles per litre so as to minimise risk of bleeding
  • notify histopathologist of the time of biopsy

Obtaining the tissue sample:

  • ultrasound or CT guidance
  • tissue usually taken from lateral border of lower pole
  • modern needles tend to be of the Tru-cut type
  • patient under local anaesthetic

After care:

  • keep patient in hospital for 24 hours - bed rest for the first 12 hours
  • monitor pulse, blood pressure, urine output - every 15 minutes, then half-hourly, hourly as appropriate to clinical status
  • observe for complications

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