RT Book, Section
A1 Dirkx, Tonja C.
A1 Woodell, Tyler
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
SR Print(0)
ID 1166170493
T1 Kidney Biopsy
T2 Current Medical Diagnosis and Treatment 2020
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260455281
LK accessmedicine.mhmedical.com/content.aspx?aid=1166170493
RD 2022/05/22
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.