Renal Biopsy



A renal biopsy should be considered in a pa­tient with parenchymal renal disease when the diagnosis or the extent of disease cannot be as­certained by the studies outlined earlier. Most renal biopsies are performed when a glomerular lesion is suspected. It is often clinically important that the disease be diagnosed before commencing treatment with potent drugs such as corticoster­oids or immunosuppressive agents. The percu­taneous biopsy is the most commonly employed technique and is a relatively safe procedure. An open renal biopsy is considered in the patient with a solitary functioning kidney or a bleeding diathesis when adequate hemostasis is critical to prevent loss of the kidney. The biopsy specimen should be submitted for light, immunofluores-cent, and electron microscopy. Potential compli­cations of a renal biopsy include hematuria, renal hematoma, vascular laceration with the devel­opment of arteriovenous fistulas, or the inadvert­ent biopsy of liver, spleen, or bowel.