To accurately determine the type of histological lesion, the level of disease activity, and its chronicity, kidney biopsy is considered the “gold standard.” This procedure allows direct evaluation of the glomeruli, renal tubules, interstitium, and blood vessels under light microscopy, immunofluorescence microscopy, and electron microscopy.

Many patients feel anxious when hearing the term “biopsy”: Is it painful? Is it dangerous? Why not rely solely on ultrasound or CT scans? Master of Medicine, Resident Physician Ngo Thi Hoai from the Kidney – Urology & Dialysis Center, Bach Mai Hospital, provides clear and scientific explanations to address these concerns.

What Is a Kidney Biopsy?

According to Dr. Ngo Thi Hoai, a kidney biopsy is a procedure that uses a very fine, specialized needle to obtain a small sample of kidney tissue under precise ultrasound guidance. The specimen is then analyzed using modern histopathological techniques.

Thanks to this small tissue sample, physicians can:

Accurately identify the specific kidney disease, such as minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, IgA nephropathy, or lupus nephritis. In kidney transplant recipients, biopsy can also help detect early signs of acute rejection.
Assess the severity of damage, determining the stage of the disease and its potential for reversibility.
Individualize treatment, selecting the most appropriate therapeutic regimen while avoiding unnecessary use of potent immunosuppressive medications and minimizing adverse effects.

When Is a Kidney Biopsy Needed?

Not all kidney patients require a biopsy. Physicians recommend the procedure when non-invasive tests are insufficient to reach a definitive diagnosis, particularly in cases of:

Persistent and significant proteinuria
Nephrotic syndrome (severe edema, low serum albumin)
Unexplained hematuria after ruling out stones or urinary tract infections
Rapid decline in kidney function requiring identification of an acute cause
Systemic diseases such as systemic lupus erythematosus with suspected renal involvement
Post–kidney transplant monitoring to evaluate possible rejection
“Ultrasound only shows the external appearance of the kidney, whereas biopsy allows us to look inside the body’s ‘blood filtration factory’ to determine exactly which cells are damaged,” Dr. Hoai emphasized.

Is a Kidney Biopsy Painful?

This is the most common concern. At Bach Mai Hospital, the procedure is performed gently and under strict monitoring:

Local anesthesia: Patients typically feel only a slight prick similar to a routine injection.
Ultrasound guidance: Ensures accurate needle placement and minimizes the risk of injury to blood vessels or nearby organs.
Short duration: The procedure usually takes about 15–30 minutes.
After the procedure: Most patients experience only mild back discomfort for a few hours, which subsides with rest.
Is a Kidney Biopsy Dangerous?

When performed at a specialized center by experienced physicians, kidney biopsy is considered highly safe. Mild side effects may occur, such as light pink urine due to minor bleeding at the biopsy site, which typically resolves within one to two days.

To ensure safety, patients at the Kidney – Urology & Dialysis Center undergo:

Careful coagulation testing prior to the procedure
Close monitoring of pulse, blood pressure, and urine color afterward
Strict bed rest as instructed by nursing staff to stabilize the biopsy site
Why Choose the Kidney – Urology & Dialysis Center, Bach Mai Hospital?

As a leading nephrology center in Vietnam, the Center brings together experienced specialists capable of managing complex cases and coordinating multidisciplinary care when necessary (such as renal artery embolization in rare complications).

Ultrasound-guided biopsy is performed under strict aseptic protocols, in close collaboration with the Department of Pathology to ensure accurate histopathological results—providing a solid foundation for effective, long-term treatment.