What are the contraindications to percutaneous kidney biopsy?
The absolute contraindications for performing a percutaneous kidney biopsy, as defined by the Health and Public Policy Committee of the American College of Physicians in 1988, include:
• Uncooperative patient
• Solitary native kidney
• Uncontrolled severe hypertension
• Uncontrolled bleeding diathesis
With the exception of an uncontrolled bleeding diathesis, many consider these to be relative contraindications, which may be overridden in specific clinical circumstances. Percutaneous kidney biopsy of a solitary kidney has been performed successfully in small studies with technological advances of real-time ultrasound guidance and the use of automated needles. Other relative contraindications include:
• Active pyelonephritis
• Perinephric abscess
• Skin infection over the biopsy site
• Hydronephrosis
• Multiple cysts
• Kidney tumor
• Small hyperechoic kidneys
• Uncontrolled hypertension
• Hypotension
