What are contraindications for renal biopsy in the workup of azotemia?

Updated: Sep 19, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Contraindications for percutaneous renal biopsy include the following:

  • Uncorrectable bleeding diathesis

  • Small kidneys

  • Severe hypertension

  • Multiple bilateral cysts or renal tumor

  • Hydronephrosis

  • Active renal or perirenal infection

  • Uncooperative patient

Percutaneous biopsy may be performed in selected patients with a solitary kidney because of the generally low risk of bleeding. Open renal biopsy may be performed if a percutaneous attempt is either unsuccessful or contraindicated and if the benefits of diagnosis outweigh the risks. When percutaneous biopsy is contraindicated but a diagnosis is necessary, a transvenous transjugular renal core biopsy can be performed. [11] With this approach, bleeding occurs intravascularly, thereby reducing the risk of hematoma.

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