Renal biopsy
A renal biopsy takes a tiny sample of kidney tissue so it can be examined under a microscope. It's the only way to definitively diagnose many kidney diseases — like specific types of nephritis, nephrotic syndrome, or unexplained kidney failure.
What happens
You'll lie face down on a table. The area over your kidney is numbed with local anesthetic. Using ultrasound guidance to see the kidney in real time, a doctor inserts a thin needle through your back and into the kidney to collect 1–2 tiny tissue samples. The procedure takes about 30–60 minutes and you'll be monitored for 4–6 hours afterward.
What to expect
Some soreness at the biopsy site for a few days is normal. You'll be asked to rest and avoid strenuous activity for about a week. A small amount of blood in urine after the procedure is expected — but report heavy bleeding, severe pain, or fever to your doctor immediately.
Percutaneous nephrostomy
This procedure creates a temporary drainage path for the kidney when urine is blocked and can't flow normally. A blockage — from a stone, tumor, scar tissue, or other cause — can cause a kidney to swell painfully (hydronephrosis) and eventually damage it permanently if not relieved.
What happens
Under imaging guidance (ultrasound or fluoroscopy), a thin tube (catheter) is inserted through the skin of your back directly into the collecting system of the kidney. Urine drains through this tube into a bag outside your body, relieving pressure on the kidney. The tube may stay in for days to weeks while the underlying cause is treated.
Intravenous pyelogram (IVP)
An IVP is an X-ray study that uses contrast dye to create detailed images of the kidneys, ureters, and bladder. It shows the size and shape of the kidneys and identifies blockages, stones, or structural abnormalities.
IVP has largely been replaced by CT scan and MRI in modern practice, but may still be ordered in some situations. The contrast dye is injected into a vein in your arm, and a series of X-rays are taken as it passes through your urinary system.
Renal arteriogram (renal angiography)
This procedure creates detailed images of the blood vessels supplying the kidneys to diagnose conditions like renal artery stenosis (narrowing of the arteries), aneurysms, or to evaluate blood flow before kidney surgery or transplant.
A thin flexible tube (catheter) is inserted into an artery in your groin or wrist and guided up to the kidney arteries. Contrast dye is injected, and X-ray images are taken. The procedure can also be therapeutic — if a narrowed artery is found, a balloon (angioplasty) or stent can sometimes be placed during the same procedure to open it.
Renal venogram
Similar to an arteriogram but examines the veins draining the kidneys. Used to diagnose renal vein thrombosis (blood clot in the kidney vein), evaluate for renal vein compression, or assess kidney donors before living donation.
Renal nuclear medicine scan
A nuclear scan uses a small amount of radioactive material injected into a vein to create detailed functional images of the kidneys. Unlike CT scans (which show structure), nuclear scans show how well each kidney is working — blood flow, filtration, and drainage. Commonly used to evaluate kidney function after a transplant, assess blood pressure-related kidney disease, or check kidney function in children.
The radioactive material is very low dose and leaves your body quickly through urine. The scan itself is painless.
Nephrectomy
Nephrectomy means surgical removal of a kidney. It may be recommended for kidney cancer, a severely damaged non-functioning kidney, living kidney donation, or in rare cases of uncontrollable kidney infection.
Most nephrectomies today are done laparoscopically — using small incisions and a camera — which means shorter hospital stays and faster recovery than traditional open surgery. You can live a full, healthy life with one kidney — the remaining kidney compensates over time.
Renal abscess drainage
A renal abscess is a pocket of infection (pus) inside or around the kidney, usually caused by a severe bacterial kidney infection that hasn't responded to antibiotics alone. Treatment involves draining the abscess — either by a radiologist inserting a thin needle under imaging guidance, or in some cases through surgery — combined with a course of IV antibiotics.