Kidney Biopsy and igA nephropathy (UPDAT... - Early CKD Support

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Kidney Biopsy and igA nephropathy (UPDATE POST-BIOPSY)

agirlwithhope95
agirlwithhope95

Hi. I am due for a kidney biopsy next week and wasn't given much tips on what to prepare or not do post biopsy other than stay in bed for 6hrs. Doctor told me that I might have igAn based on my proteinuria and high hematuria. I am very concerned as I am only 24 years old and a female trying to start a family soon. I only noticed my hematuria last year and doing a biopsy almost one year after my creatinine level hit 1.77, it was 0.74 on my first ever visit to the A&E. my HB and red blood cells count are relatively low at hb=10.1 too. Would love to hear from people of experience or any words of advice/comfort would help ❤️

Hi everyone. Here's an update as i lie on the hospital bed post-biopsy. The procedure was a 20mins long from start to end. You have to lie on your tummy with a pillow on your tummy so as to "push-up" the organs and easier for the doctor to reach your kidneys. My biopsy was an ultrasound guided biopsy and only on the left kidney. Firstly, the doctor will use the ultrasound to find the right spot on the kidney for the biopsy sample and mark it with a marker. Afterwards, the nurses will clean up the site and cover the other areas with sterile drapes/cloth, they might also cover part of your vision so technically you can just close your eyes throughout. I also closed my eyes bcos I was very very anxious throughout the whole procedure. The most painful part/the only part you would feel is when they inject the local anesthesia on your skin surrounding the area that they're puncturing for the biopsy. Honestly, it felt like liquid spreading under your skin and it really burns/stings for a good 3 seconds. My doctor was rly kind to pre-empty me everything and letting me know what's happening as I could not see since I was lying face down on my tummy. When he inserted the biopsy gun, there was no pain, I can merely feel him tugging at my back. There were specific breathing instructions given as he pulled the trigger on the biopsy gun so that your kidney does not move out of the ideal position. He took two samples for me. Afterwards, the nurses will apply pressure on the punctute site and compression bandage. I was on complete bed rest for the next 6hrs, also I was too sore to move much. Now, is the next day after biopsy and I have tried walking. I realised that I am unable to lift up my left leg as my biopsy side was on the left kidney. I will feel a pulling strain on my back when i try to lift my left leg so i really do things slower now especially when wearing of pants or going up the stairs. My right side is totally normal. So I do have to adjust the way I get out of bed and sitting up from lying position. The doctors did mention not to carry heavy weights or engage in strenuous activities such as exercising. I also do realise that I am unable to rush for a bus or be in a hurry as it will trigger the pain on my back, which I think that you should not force yourself too as you would not want to cause any bleeding or further trauma to your skin and kidneys. Other than that, if anyone reading this is preparing for their kidney biopsy, I would say that it is very doable, there would be slight pain during the LA but it is tolerable and the rest of the procedure is very smooth sailing as the LA will magically numb the area and you won't feel a thing. So don't be afraid and the procedure is for your own good so as to know exactly the diagnosis for your kidney condition. Emotional support is definitely extremely important. I am glad and grateful to have this community to engage with while going through this new journey, for me. May we all be positive and support one another. Life is too short to let our kidneys get in the way. ❤️❤️

12 Replies
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Based on my own experience (a week in hospital about twenty years ago with pneumonia where the infection was starting to jeopardize my kidneys), I discovered that a 'kidney biopsy', while medically necessary in your situation I imagine (if in doubt, a 2nd opinion is urged), may carry some risk of death (1%?).

When I do online searches on the topic now, I'm unable to find a clear risk assessment of that character any longer (so, perhaps things have improved and it's much lower risk?).

wbiC
wbiC in reply to wbiC

This looks reassuring:

cjasn.asnjournals.org/conte...

agirlwithhope95
agirlwithhope95 in reply to wbiC

thank you for the meta analysis! hopefully everything goes smoothly for me

Hi agirlwithhope,

I love that user name btw! Don’t ever let anyone take that away from you!

Anyhow, I can’t advise on a kidney biopsy as I was all gowned up for mine when they decided they’d figured the cause of my dodgy kidneys without doing it. But I’ve had both a liver and pancreas biopsy done. Both have been similar, as in local anaesthetic is injected into the area...that’s the bit I found a bit ouchy. Both biopsies were very quick...they just took what they needed and that was the actual procedure done in a few minutes. I had to lie on my side for 6 hours both times...it’s just to stop it bleeding I think...the same as you’d put pressure on a little cut on your finger to stop it bleeding. The nurse will do regular checks of your blood pressure and temperature and sats and hopefully you’ll be good and ready to go home again after that!

Sorry to hear you have these problems so young! I was 19 when I got sick with some rare autoimmune disease causing pancreatitis and in the last 8 years (no 42) chronic kidney failure. Ask the doctors all the questions you want to! I hope you have a good consultant who will do all that he can for you!

Take care!

Dee x

Thank you Dee, you're too kind. The biopsy doesn't sound too scary. Thank you for sharing your experience and story. I feel assured hearing it from the person himself. Hope all is well for you too.

Take care!

You’re welcome!

I don’t know about IgAn ...will look it up!

Forgot to say no question is silly so don’t be afraid to ask! And if you don’t understand something they tell you, just ask them if they can explain it again! I’ve found my consultants are always willing to explain and help me understand the best they can.

My eGFR is now 37....it’s not dropped too much since when I joined this site in 2013.

Take care!

Dee x

Hi, In 1996 I had my right kidney removed due to having medullary sponge kidney, in 1999 I had a biopsy and I was diagnosed with IGA , I have been very fortunate, my IGA has not greatly impacted on my life, I have continued to work, I was 38 when diagnosed.

Wow I am so happy to hear that your igAn has not negatively impacted your life. Hopefully it stays that way. I cannot imagine the recovery you've had to go through from the removal of your right kidney too. Are you on any medication due to the conditions you face? Would like to hear/know about the medicine and any side effects/life style changes incurred.

Thank you and take care! xx

Hi,I have to take Ramapril and Amlodipine for blood pressure and ezetrol for cholesterol, these meds protect my kidney. When I had my biopsy I had to stay in bed without moving for 12 hours, this was because I only have the one kidney. I can honestly say the hospital were brilliant when they did the biopsy, Like yourself I had protein and hematuria in my urine, I still have microscopic traces of blood in my urine now. Please remain positive.

Hope everything goes well.

Thank you for sharing your medications with me and thank you for the boost of positivity. Hearing your story really comforts me knowing that I can still be strong and living my life normally despite having some differences as compared to "normal" people.

Fit

xx

Fit,

You are a" normal " person; you just are among the chosen to have a kidney issue.

I understand how you feel as everyone of us have felt as you do when those words were spoken to us.

Just remember that this is all a process; it takes time for evaluation and to set you forth on an action plan to address the IGAN.

Every consultant is different, with different approaches and assignment of medications as every patient is different.

As pqe told you, they will more than likely put you on blood pressure medication as first line treatment to slow the protein spilling and protect the kidneys. If you have high blood pressure, elevated cholesterol or diabetes, your medication will be different than someone without this.

In the US, Lisinopril, an ACE inhibitor, is widely used to address protein spilling and protect the kidneys. It is the sister drug to Ramapril , which is more widely prescribed in the U.K. Here, Losartan, an Angiotensin II receptor blocker is also widely used.

I am on a very low dose of Lisinopril as my BP is low to low normal. I am on this to protect my kidneys.

They will also monitor your glucose, CBC, cholesterol and electrolytes such as sodium, potassium and phosphorous, levels, your iron, protein, albumin, calcium, vitamin B12 and D levels in addition to kidney function as creatinine, GFR, albumin to creatinine ratios, BUN and anion gap.

What medications you are given will depend on your test results as everyone is different. The keys are water, healthy eating and a tad of exercise.

Unfortunately, there is no cure for kidney disorders , but they can be dealt with - the goal is to keep them in check and stop progression. You are still BEAUTIFUL you.

Go one step at a time as it will all work out.

We will all be here to support you; just reach out as one of us will always reach back. You are among friends!

Bet xx

Fit,

Thinking of you as you go through the biopsy as it will tell the story.

Take a breath and ask any questions that may come up.

My actual procedure was about 15 minutes. Once in the procedure room, they gave me sedation to relax me, oxygen which is standard, and monitored vitals. My nurse assigned to my case was with me. The radiologist then did an ultra sound. I felt a pinch when the surgeon numbed the kidney, a tad of pressure when they prepared the area for the needle insertion and then a pop.

Once the samples were taken, the area was cleaned, my vitals checked and I was taken back to the area where I started. My vitals such as BP, oxygen level were carefully monitored.

I needed to remain on my back to put pressure on the area to prevent bleeding.

I was also given water and ginger ale as well as a snack as before they discharge you, they will want a urine sample to look for bleeding etc. and to see you off the bed. Fortunately, no problems. This was roughly 2-3 hours and my husband sat with me before discharge.

Before being discharged, my surgeon came by; checked my chart, vitals and spoke to me.

My discharge instructions were clear and I had a number to call in case there was a problem.

Once home, I was ordered to bed rest for several days; again on my back and no lifting of objects. I wasn't groggy or had any discomfort. No dietary restrictions.

My nephrologist called me three days later with a preliminary diagnosis and the final report was available within a week and a half.

Most importantly, make sure that you rest and pamper yourself after the procedure.

It is annoying, but once it is done and over, it becomes one more experience in a lifetime; one we can do without, but yet an experience.

It will all be good.

Please let me know how it goes. I will be at your side, cheering you on!

Bet xx

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