Percutaneous renal biopsy of the solitary kidney: a contraindication?
We recently were presented with a patient from the nephrology service, with the request to perform open renal biopsy because of a solitary functioning kidney. We performed the open biopsy and the patient subsequently had a wound infection, leading us to question the recommendation in the literature stating that a solitary kidney is an absolute contraindication for percutaneous renal biopsy. In a review of the literature from 1951 to 1990, a total of 19,459 percutaneous renal biopsies has been reported with an overall complication rate of 2.1 to 10.8%, the majority (90%) of which did not require definitive treatment. Only 13 nephrectomies (0.06%) were required secondary to complications. The overall mortality rate was 0.08%. We reviewed 157 percutaneous renal biopsies done at this institution from 1985 to 1990 with a minor complication rate of only 5% and no major complications or loss of kidney function. The mortality rate was 0. Based on our study and a review of the literature, both showing an extremely small percentage of permanent loss of kidney function or mortality, we propose that a solitary kidney no longer be recommended as an absolute contraindication to percutaneous renal biopsy.
Schow
D A
DA
Department of Urology, Medical Center Hospital of Vermont, Burlington.
Vinson
R K
RK
Morrisseau
P M
PM
D001706:Biopsy / Q000379:methods; D000075202:Contraindications; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000473:pathology*; D011183:Postoperative Complications / Q000453:epidemiology; D012867:Skin