Needling You

I haven’t had a kidney biopsy, but many of my readers have. One of them requested a blog about kidney biopsies. Looks like I’m going to learn along side of you again. Frankly, I enjoy the learning.

Okay now, what is a kidney biopsy? Obviously, whatever it is is performed on the kidney. Here’s how MedlinePlus explains the biopsy part of that phrase:

“A biopsy is a procedure that removes cells or tissue from your body. A doctor called a pathologist looks at the cells or tissue under a microscope to check for damage or disease. The pathologist may also do other tests on it.

Biopsies can be done on all parts of the body. In most cases, a biopsy is the only test that can tell for sure if a suspicious area is cancer. But biopsies are performed for many other reasons too.

There are different types of biopsies. A needle biopsy removes tissue with a needle passed through your skin to the site of the problem. Other kinds of biopsies may require surgery.”

Let’s see how a kidney biopsy is performed, courtesy of RadiologyInfo:

“Most areas of the body can be biopsied with a needle device. This is the least invasive option, and usually allows for the patient to return home the same day. Imaging guidance with x-ray, ultrasound, CT or MRI allows for accurate placement of the needle to locate the best place to take a tissue sample.

In hard to reach places, biopsies using surgery in a hospital operating room may sometimes be necessary. A surgeon will perform surgery to remove the tissue needed for the biopsy. The surgeon may use an instrument with a camera to help locate the best place to biopsy and remove the tissue sample.

Using imaging guidance, the doctor inserts the needle through the skin and advances it into the lesion.

They will remove tissue samples using one of several methods.

• In a fine needle aspiration, a fine gauge needle and a syringe withdraw fluid or clusters of cells.
• In a core needle biopsy, the automated mechanism moves the needle forward and fills the needle trough, or shallow receptacle, with ‘cores’ of tissue. The outer sheath instantly moves forward to cut the tissue and keep it in the trough. This process is repeated several times.
• In a vacuum-assisted biopsy, the doctor inserts the needle into the site of abnormality. They activate the vacuum device, which pulls the tissue into the needle trough, cuts it with the sheath, and retracts it through the hollow core of the needle. The doctor may repeat this procedure several times.”

There’s quite a bit of medical terminology in the blog so far, so I concocted a little dictionary for us. Of course, I used my favorite dictionary [Let me know if you’re tired of me saying that.], the Merriam-Webster.

CT: a method of producing a three-dimensional image of an internal body structure by computerized combination of two-dimensional cross-sectional X-ray images. abbreviation CT. called also computed axial tomography, computerized axial tomography, computerized tomography

MRI: magnetic resonance imaging  –  a noninvasive diagnostic technique that produces computerized images of internal body tissues and is based on nuclear magnetic resonance of atoms within the body induced by the application of radio waves [Gail here: this is the one where you have to make sure you’re not wearing anything with metal in it.]

Ultrasound: 1 – vibrations of the same physical nature as sound but with frequencies above the range of human hearing 2 – the diagnostic or therapeutic use of ultrasound and especially a noninvasive technique involving the formation of a two-dimensional image used for the examination and measurement of internal body structures and the detection of bodily abnormalities. called also sonography, ultrasonography

x-ray: 1 – any of the electromagnetic radiations that have an extremely short wavelength of less than 100 angstroms and have the properties of penetrating various thicknesses of all solids, of producing secondary radiations by impinging on material bodies, and of acting on photographic films and plates as light does 2 – a photograph obtained by use of X-rays.

But we’ve got kidney disease. There’s something you should know about the contrast that may be ordered along with your CT if that’s the guiding imagery your doctor will be using to perform the biopsy. For example, I have a CT with contrast every six months to make sure the cancer hasn’t returned. Because I have kidney disease, a blood test comes first to find my creatinine level. If it’s over 1.1, no contrast would be used. This is the purpose of the contrast:

“In a CT scan, dense substances like bones are easy to see. But soft tissues don’t show up as well. They may look faint in the image. To help them appear clearly, you may need a special dye called a contrast material. They block the X-rays and appear white on the scan, highlighting blood vessels, organs, or other structures.

Contrast materials are usually made of iodine or barium sulfate. You might receive these drugs in one or more of three ways:

• Injection: The drugs are injected directly into a vein. This is done to help your blood vessels, urinary tract, liver, or gallbladder stand out in the image.
• Orally: Drinking a liquid with the contrast material can enhance scans of your digestive tract, the pathway of food through your body.
• Enema: If your intestines are being scanned, the contrast material can be inserted in your rectum.”

Thankyou for the above information, WebMD.

Hmm, since I haven’t had any, I wondered what the purpose of kidney biopsies was. The National Kidney Foundation tells us:

• “Blood (hematuria) or protein (proteinuria) in the urine 
• Abnormal blood test results
• Acute or chronic kidney disease (CKD) with no clear cause
• Nephrotic syndrome and glomerular disease (which happens when the filtering units of the kidney are damaged)
• See if kidneys are responding well to treatment
• Check if kidneys are permanently damaged
• Learn why a transplanted kidney is not working well
• See if a kidney tumor is cancerous
• Check for other unusual or special conditions
• See if any medications are hurting your kidneys”

There’s so much more to know about a kidney biopsy, but I’ve just plain run out of room today.

Until next week,

Keep living your life!