A number of conditions may pose problems if a percutaneous needle biopsy of the kidney is performed.


Bleeding disorder (biopsy after reversal or treatment of bleeding disorder):

(1) congenital or acquired bleeding disorder

(2) anticoagulation with heparin or coumadin

(3) antiplatelet agent


Increased risk of bleeding:

(1) severe hypertension

(2) renal amyloidosis

(3) polyarteritis nodosa


Increased risk of trauma:

(1) inexperienced operator without supervision

(2) lack of ultrasonography or other imaging modality

(3) uncooperative or constantly moving patient (may be possible with sedation and restraint)


Increased risk of perinephric abscess:

(1) sepsis

(2) untreated pyelonephritis


Reduced risk if performed under direct observation (open biopsy or real time imaging with an experienced operator):

(1) solitary or horseshoe kidney

(2) renal mass lesion

(3) marked hydronephrosis

(4) polycystic kidney disease


Information obtained may not justify risk:

(1) chronic renal failure with bilateral small and contracted kidneys

(2) no clear indication


Lack of informed consent


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