TY - CHAP M1 - Book, Section TI - Kidney Biopsy A1 - Dirkx, Tonja C. A1 - Woodell, Tyler A2 - Papadakis, Maxine A. A2 - McPhee, Stephen J. A2 - Rabow, Michael W. Y1 - 2020 N1 - T2 - Current Medical Diagnosis and Treatment 2020 AB - Indications for percutaneous needle biopsy include (1) unexplained AKI or CKD; (2) unexplained proteinuria and hematuria; (3) previously identified and treated lesions to guide future therapy; (4) systemic diseases associated with kidney dysfunction, such as systemic lupus erythematosus (SLE), anti-GBM disease (Goodpasture syndrome), and granulomatosis with polyangiitis (eFigure 22–3), to confirm the extent of renal involvement and to guide management; and (5) kidney transplant dysfunction, to evaluate for transplant rejection or other causes of AKI. Importantly, kidney biopsies typically should be performed only if the results will influence the treatment plan or facilitate discussion about prognosis; patients unwilling to accept therapy based on biopsy findings should not undergo kidney biopsy. Relative contraindications include a solitary or ectopic kidney (exception: transplant allografts), horseshoe kidney, ESRD, congenital anomalies, and multiple cysts. Absolute contraindications include an uncorrected bleeding disorder; severe uncontrolled hypertension; renal infection; renal neoplasm; hydronephrosis; or uncooperative patients, including those who are unable to lie flat for the procedure. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2022/05/18 UR - accessmedicine.mhmedical.com/content.aspx?aid=1166170493 ER -