Is it necessary to do renal biopsy for kidney failure patients? When doctor
finds out that there is some thing abnormal in your urine and doubt that maybe
you have got kidney disease, he will suggest you have a renal biopsy. With a
very thin needle, doctor can get some tissue of kidney and then observe under
microscopy. This operation seems small, which is risky however. Renal biopsy is
blind to some extent. When the needle hurts blood vessels, it will lead to
bleeding and even shock due to large amount of blood lost. In addition, renal
biopsy can also damage the tissues or organs nearby such as liver, spleen, guts
and so on.
Renal biopsy has so many risk, why does doctor suggest you to do it due to
little amount of protein in urine? There are many kinds of kidney diseases,
nearly all of which have hematuria and or proteinuria. It means that although we
can guess you have got kidney disease, we don’t know which kinds of kidney
disease you have got and we don’t know the pathological change inside of the
kidney.
Many people hold an idea that if the protein in urine is not so much, it is
not necessary to do renal biopsy. It is absolutely wrong. For some people,
although the protein in urine is +, the damage inside of the kidney has already
been serious. In contrast, some kidney disease patients have 4+ protein in
urine, but the renal biopsy shows the damage inside of the kidney is slight.
Minimal change is an example. To sum up, we can not judge the change of kidney
just from urine tests.
On the other hand, some doctors suggest patients do renal biopsy test as soon
as they find out that there is abnormality in urine. It is also wrong. Before
doing renal biopsy, we must figure out two points:
1. figure out whether abnormal urine is caused by kidney damage.
2. figure out whether kidney disease is caused by systematic disease, namely,
figure out whether kidney disease is secondary kidney disease
