What are the complications of renal biopsy in the workup of azotemia?

Updated: Apr 24, 2020
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Percutaneous renal biopsy is associated with potential complications. Severe bleeding causing hypotension occurs in 1-2% of patients. Bleeding necessitating transfusion occurs in about 0.1-0.3% of patients. Bleeding complications can be minimized by performing pre-procedure coagulation studies—bleeding time, prothrombin time (PT), activated partial thromboplastin time (aPTT), and platelet count.

Nonsteroidal anti-inflammatory drugs (NSAIDs) should be stopped at least 1 week before a scheduled elective biopsy. Patients on warfarin should be started on heparin at least 3 days before kidney biopsy. Patients who are taking heparin for other reasons should stop the drug for at least 1 day.

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