1. Ministry of Health
Dakahlia Medical diroctorate
New Mansoura General Hospital
Nephrology Department
Renal Biopsy Protocol
Dr. Shaymaa Abd ElatefDr. Mohamed Abd Elgawad
Resident of nephrology
New Mansoura General Hospital
Assistant Specialist of nephrology
New Mansoura General Hospital
Dr. Osama El Shahat
Consultant of Nephrology
Head of nephrology department
New Mansoura General Hospital

2.  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 before biopsy 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 the clotting 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 placed underneath the abdomen to ensure appropriate positioning

3.  Post Biopsy Patient Assessment & Nursing Care:
o General condition and pain assessment.
o Check for hematuria if positive follow 3 sources samples.
o Keep NPO for 4 Hrs
o 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 .
o the patient is asked to lie flat on his back for 4–6 hours
o Pressure dressing over the renal biopsy site to avoid bleeding.
o Check CBC 6 h after the biopsy and next day if positive hematuria.
o Obtain kidney US next morning.