Renal biopsies are used to help investigate reasons for kidney function decline, diagnose kidney diseases, and assess how well a transplanted kidney is working. Learn how renal (kidney) biopsies are performed, how to prepare for one, and what to expect.*

How kidney biopsies are performed

A kidney biopsy may be performed as an outpatient procedure, or in a hospital, either on a hospital bed or in a radiology department procedure room. The two primary forms of kidney biopsy are percutaneous (“through the skin”) and open.

Percutaneous biopsy

Percutaneous is the most common type of biopsy. Here’s what to expect. 

• A technician may or may not start an IV in your arm or hand.
• If the biopsy is of your natural kidney, you’ll be asked to lie on your stomach; if you have a transplanted kidney, you’ll lie on your back.
• The doctor or technician will clean the area, then inject a numbing local anesthetic under the skin near your kidney. You may feel a brief stinging sensation.
• They will then make a small incision in the skin, using ultrasound or CT imaging to locate the appropriate spot to insert the biopsy needle.
• The doctor will ask you to take a deep breath and hold it as they insert the needle into your kidney. This may occur more than once, depending on the number of tissue samples needed. 
• Once the biopsy is over, the doctor will generally use gauze to apply pressure to stop any bleeding at the site, then apply a bandage.

Open biopsy

Open, or surgical, biopsy is used to obtain a larger tissue sample. For this procedure:

• You are given general anesthesia to help you sleep through the biopsy process.
• Your surgeon will:
  • Make a small incision,
  • Remove the needed kidney tissue, and 
  • Use stitches (also called sutures) to close the incision. 

After the biopsy

Biopsy procedures carry a slight risk of infection. You’ll likely remain in the hospital for at least 12 hours following the biopsy, regardless of which type of biopsy you’ve undergone. You’ll be given fluids and pain medication (by mouth or IV). Staff will monitor your urine for bleeding; a little bit of blood during the first 24 hours is normal. You may continue to feel some soreness in the biopsied area for a few days, and your surgeon may recommend that you not do any heavy lifting for around two weeks. 

Preparing for the biopsy

Prior to the biopsy, make sure to inform your doctor about any:

• Allergies you have
• Possibility that you may be pregnant
• Medications you are taking, including:
  • Over-the-counter medicines
  • Vitamins, supplements, and herbal remedies
  • Blood thinners, such as:
    • Apixaban (Eliquis)
    • Aspirin
    • Clopidogrel (Plavix)
    • Dabigatran (Pradaxa)
    • Dipyridamole (Persantine)
    • Fondaparinux (Arixtra)

Speak with your doctor about any questions or concerns you may have concerning your upcoming procedure.

*Mount Sinai Healthcast Newsletter. (2023). Kidney Biopsy. https://www.mountsinai.org/health-library/tests/kidney-biopsy#:~