Contraindications and complications of Renal Biopsy
Journal of Kidney Treatment and Diagnosis consists of the latest findings related to pathogenesis and treatment of kidney disease, hypertension, acid-base and electrolyte disorders, dialysis therapies, and kidney transplantation.
Renal biopsy (also kidney biopsy) is a medical procedure in which a small piece of kidney is removed from the body for examination, usually under a microscope. Microscopic examination of the tissue can provide information needed to diagnose, monitor or treat problems of the kidney.
The safety of renal biopsy is affected by the following conditions:
- Bleeding diathesis
- Uncontrolled severe high blood pressure
- Uncooperative patient
- Presence of a solitary native kidney
- Azotemia or uraemic
- Certain anatomical abnormalities of the kidney
- Skin infection at the biopsy site
- Medications that interfere with clotting (e.g. warfarin or heparin)
- Urinary tract infection
- Serious complications of renal biopsy are uncommon. The risk of complications will vary from center to center based on experience and other technical factors.
- The most common complication of kidney biopsy is bleeding. This reflects the density of blood vessels within the kidney and observation that individuals with kidney failure take longer to stop bleeding after trauma (uraemic coagulopathy). Bleeding complications include a collection of blood adjacent to or around the kidney (perinephric hematoma), bleeding into the urine with passage of blood stained urine (macroscopic haematuria) or bleeding from larger blood vessels that lie adjacent the kidney. If blood clots in the bladder, this can obstruct the bladder and lead to urinary retention. The majority of bleeding that occurs following renal biopsy usually resolves on its own without long-term damage. Less commonly, the bleeding may be brisk (causing shock) or persistent (causing anemia) or both.
- Infection is rare with modern sterile operating procedures. Damage to surrounding structures, such as bowel and bladder (more likely with transplant kidney biopsy), can occur.
- Occasionally, a biopsy will have to be abandoned prematurely due to technical issues such as inaccessible or small kidneys, obscured kidneys, difficult to penetrate kidneys or observation of bleeding complication. Further, after the biopsy has been completed, microscopic examination of the tissue may reveal heavily scarred tissue prompting recommendation for re-biopsy to avoid sampling error.
- As with all treatments, there is a risk of allergy to the disinfectant solution, sedation, local unaesthetic and materials (latex gloves, drapes, dressings) used for the procedure.
- Finally, the biopsy needle may join an artery and vein in the kidney, resulting in the formation of an arteriovenous fistula. These usually do not cause problems and close on their own. They may be monitored over time with repeat Doppler ultrasonography. Rarely, they may result in intermittent bleeding into the urine or may grow in size and threaten to burst. In these instances, the fistula may be closed surgically or with angioembolisation.
Journal of Kidney Treatment and Diagnosis publishes the manuscripts that are directly or indirectly based on variegated aspects of Articles that are submitted to our journal will undergo a double-blind peer-review process to maintain quality and the standards set for academic journals. The review process will do by our external reviewers which are double-blind. The comments will upload directly to the editorial tracking system. Later the editor will check the comments whether it is acceptable or not. The overall process will take around 21 days under with the editor. After acceptance by the editor, it will be published on the Press page. Authors can submit their manuscripts to the online submission portal
Journal of Kidney Treatment and Diagnosis