Renal Biopsy protocol • Pre-Procedure:

1. Patient admission.

2. Pre-biopsy patient assessment by Medical Staff.

3. Vital Signs .

4. Check for signed of consent.

5. Work up lab CBC and Coagulation profile ( INR, PT,PTT and Bleeding time)

6. Send blood sample for type and hold one unit of blood

7. NPO for 6 h except medications.

8. Patient I.V Canula

9. Check for Histopathology.

10. An ultrasound or other imaging study of the kidney may be performed beforebiopsy to exclude structural problems of the kidney.

11. Send blood sample for type and hold one unit of blood .

12. Check if patient is not on ASA, Warfarin or Plavix

13. Desmopressin may be administered intravenously in the hope of reversing theclotting disturbance that accompanies kidney failure ( uraemic coagulopathy ).

14. Strict control of blood pressure is also important to reduce bleeding risk.

Procedure

Anesthesia

Renal biopsy is performed under local anesthesia using 1% lidocaine .

Positioning

The patient is placed in the prone position, usually with a towel or pillow placedunderneath the abdomen to ensure appropriate positioning

• Post Biopsy Patient Assessment

• General condition and pain assessment.

• Check for hematuria if positive follow 3 sources samples.

• Keep NPO for 4 Hrs

• Take the patient’s vital signs:

- Every 15 m for one hour .

- Every 30 m for two hours.

- Every 1 h to next morning.

- Every 4 h to next morning .

• the patient is asked to lie flat on his back for 4–6 hours

• Pressure dressing over the renal biopsy site to avoid bleeding .

• Check CBC 6 h after the biopsy and next day if positive hematuria .

• Obtain kidney US next morning .