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Renal biopsy: how to do it

¹ Consultant Nephrologist, Renal Unit, ² Consultant Radiologist, Department of Radiology, Western Infirmary, Dumbarton Road, Glasgow G11 6NT, UK

• Most renal biopsies are performed on the ward; "difficult" biopsies are normally referred to radiology.
  
• Uncontrolled hypertension or systolic blood pressure >180 mm Hg is a contraindication to biopsy.
  
• Normally, two or three 20 mm length biopsy cores are required for histological diagnosis.
  
• Post-biopsy haemorrhage requiring intervention or blood transfusion occurs in 0.5% of patients.
  

The following short article is intended to show how to perform a renal biopsy and to demonstrate the traditional ward biopsy and the "radiological" method using an electronic guide system. The vast majority of biopsies are performed on the ward and radiological assistance is normally only sought for those biopsies deemed difficult, e.g. owing to patient build, depth of kidney or both, or in patients in whom the ward procedure was unsuccessful. This article, although brief, addresses all of the important issues associated with this procedure and is a useful checklist for those wishing to deliver this service.