In which cases of kidney disease is a renal biopsy particularly contraindicated?

A renal biopsy is particularly contraindicated in cases where there is a high risk of bleeding, such as in patients with uncontrolled hypertension, bleeding diatheses, or severe thrombocytopenia. It is also contraindicated in patients with a solitary kidney or small, contracted kidneys where the procedure may cause irreversible damage. Additionally, active infection at the biopsy site or systemic infection poses a contraindication due to the risk of spreading infection. Other contraindications include uncooperative patients who cannot remain still during the procedure and those with anatomical abnormalities that increase procedural risk. In the context of kidney disease, these contraindications are especially relevant when the risks of biopsy outweigh the potential diagnostic benefit, such as in advanced chronic kidney disease with small kidneys or in patients with severe coagulopathy ¹ (Stiles et al., 2000; Bandari et al., 2016; Schnuelle, 2023).

Key points: renal biopsy is contraindicated in uncontrolled hypertension, bleeding disorders, solitary or small kidneys, active infection, uncooperative patients, and anatomical abnormalities that increase risk ¹ (Bandari et al., 2016; Schnuelle, 2023).