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Native kidney biopsy preparation — ESENeph MCQ

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ModeratePractical ProceduresNative kidney biopsy preparationESENeph

A 37-year-old woman is scheduled for native kidney biopsy for unexplained proteinuria. Blood pressure is 168/96 mmHg, platelet count is 210 x 10^9/L and INR is 1.0. She took apixaban yesterday for a previous pulmonary embolism. What is the most appropriate management?

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Correct answer: D — Postpone biopsy to optimise blood pressure and anticoagulant interruption

Percutaneous kidney biopsy requires bleeding risk optimisation, including blood pressure control and appropriate interruption of anticoagulants such as apixaban. A normal INR does not exclude DOAC effect. Aspirin or thrombolysis would increase bleeding risk. The pearl is that biopsy safety depends on medication review, blood pressure, coagulation, platelet count, anatomy and post-procedure monitoring.

Reference: UKKA Kidney Biopsy guidance; BNF