OpenHealth Q&A

Reasons for Considering a Kidney Biopsy and Potential Implications

Greetings, I’ll keep this concise as I share my health concerns. **Current Medications:** - **Trintellix** 10mg (for depression and anxiety) - **Qelbree** 100mg (for ADHD) - **Meloxicam** 15mg (for pain, as needed; advised by my nephrologist to limit usage to every 3-4 days, though I had been taking it daily) - **Tizanidine** 4mg (for pain, as needed) **Diagnosed Conditions:** - Endometriosis - Hypermobility (not a formal diagnosis) - Depression, anxiety, and ADHD I am a 24-year-old female classified as obese but not morbidly so. Over the past few years, I have been struggling with persistent joint pain, lower back pain, chronic fatigue, and a lingering cough that is most pronounced at night. My partner has noted that this cough has persisted since we met four years ago. I regularly consult my primary care physician, who noted a slightly elevated ESR at 27; this prompted a referral to a rheumatologist. Additionally, I have gynecological complications, including a recently confirmed diagnosis of endometriosis, for which I am slated for surgery soon. The rheumatologist and her physician assistant have expressed uncertainty about my condition, as my lab results have generally returned normal (ANA negative, RF negative, etc.), and I show no visible signs of joint inflammation. The possibility of fibromyalgia has been raised, and a second rheumatologist also concurred, suggesting that I may have sleep apnea—something I am open to but prefer to investigate further before finalizing. A routine urinalysis revealed trace amounts of protein and 2+ occult blood. Subsequent testing showed a mild increase in urine albumin to creatinine ratio at 32. I planned to monitor this situation. A follow-up test indicated 1+ protein in the urine (no blood), which was concerning. My PCP had referred me to a nephrologist due to the earlier trace protein result, leading to the scheduling of an appointment. After extensive lab testing, results returned largely normal, including no protein presence in my urine, aside from elevated ASO antibody levels (366) and some variations like monocytosis, which seems normal for me. The nephrologist mentioned the potential of IgA nephropathy and ANCA-related vasculitis, but tests for both were negative. A kidney ultrasound revealed increased echogenicity of both renal cortices; I understand this could suggest kidney disease or be within normal limits. Though I don't recall any recent strep infection, bloodwork suggests otherwise. I often feel unwell, so I might not notice symptoms if I do contract something. Could post-streptococcal glomerulonephritis be a consideration? Recently, I experienced a spike in blood pressure, hitting 181/85; I contemplated an emergency visit, but my pressure eventually returned to the 120s, albeit with a bad headache. This was unusual for me, as my blood pressure typically tends to be on the lower side. I also have mixed hyperlipidemia, likely of genetic origin given my family history. The nephrologist has suggested that a kidney biopsy may be necessary, and I feel anxious about the procedure and the associated pain. Based on what I’ve described, does it seem likely that a biopsy is warranted? Furthermore, considering this information, what could potentially be the underlying issue, and what steps should I take next to clarify my health situation (aside from focusing on weight management, diet, and exercise)? Thank you for taking the time to read this.

Answers (1)

2/18/2026, 2:50:48 AM

OpenHealth AI

It sounds like you're navigating a complex health situation with multiple symptoms and concerns. A kidney biopsy can help clarify any potential kidney issues, especially given your recent symptoms and lab findings. Here’s a breakdown of why a biopsy might be suggested and what you can do next.

Key Points:

1. Reason for Kidney Biopsy:

   • Evaluating unexplained kidney function changes or disease.
   • Investigating proteinuria (protein in urine) and hematuria (blood in urine) that have been observed in your tests.
   • Clarifying potential conditions like IgA nephropathy or glomerulonephritis, especially when other tests are inconclusive.

2. Potential Underlying Issues:

   • IgA nephropathy (despite negative tests, conditions can sometimes not show typical markers).
   • Post-streptococcal glomerulonephritis could be a consideration, particularly if you had a past strep infection, even if unnoticed.
   • Other kidney diseases may be possible, and a biopsy would help to rule out or confirm these conditions.

Next Steps:

1. Assessing the Need for a Biopsy:

   • Consider discussing your concerns directly with the nephrologist about the biopsy, including any specific fears you have regarding pain or recovery.
   • Ask for a clear explanation of what the biopsy will help determine and the potential benefits of knowing your kidney status compared to the risks of the procedure.

2. Immediate Monitoring:

   • Keep a close eye on any changes in your symptoms, especially blood pressure changes, joint pain, fatigue, and your cough. Document any occurrences and share this with your healthcare providers.
   • Given your recent spike in blood pressure and headache, monitor your blood pressure regularly and report any significant or recurring spikes.

3. Lifestyle Considerations:

   • Maintain a healthy diet low in sodium and balanced in nutrients to support overall kidney health.
   • Stay hydrated, but be mindful if advised otherwise by your nephrologist, especially considering your mild proteinuria.

4. Follow-Up & Testing:

   • Follow through with scheduled appointments, including any additional tests your nephrologist recommends.
   • Consider asking your rheumatologist about how your current symptoms and kidney findings interact, as they may provide helpful insights.

5. Addressing Mental Health:

   • Since you're managing anxiety and depression, continue to utilize your current support systems, perhaps integrating mindfulness or relaxation techniques as you navigate these health concerns.

6. Seek Support:

   • It might be helpful to talk to a trusted family member or a friend about your feelings regarding the procedure to ease anxiety.

By following these steps, you can take an active role in managing your health and clarifying your kidney-related concerns. Remember, it’s okay to ask for help or more information from your healthcare team—your comfort and understanding of the situation are paramount.