Abstract The use of the renal biopsy has been an invaluable tool in the diagnosis and study of the natural course of many types of renal disease. However, numerous complications have been described including gross and microscopic hematuria, massive hemorrhage, arteriovenous fistula, extravasation of urine, and death in approximately 0.1% of cases.1 The occurrence of parapelvic extravasation of urine following a renal biopsy, which produced transient obstruction and hydronephrosis, is described in this report. PATIENT SUMMARY A 47-year-old man had a three-month history of increasing abdominal girth, pedal edema, and hypertension. He was initially treated at another institution with spironolactone, a mixture of triamterine and hydrochlorothiazide (Dyazide), and methyldopa (Aldomet). He then came to Tripler Army Medical Center complaining of a 13.0-kg (30-1b) weight loss, extreme fatigue, and severe muscular weakness. The patient's history is noteworthy; approximately eight years before admission, he had an evaluation for proteinuria at another hospital. References 1. Slotkin EA, Madsen PO: Complications of renal biopsy: Incidence in 5,000 reported cases. J Urol 87:13-15, 1962. 2. Kark RM: Renal biopsy. JAMA 205:220-226, 1968.Crossref 3. Ekelund L, Gothlin J, Lindholm T: Arteriovenous fistulas following renal biopsy with hypertension and hemodynamic changes: Report of a case studied by dye dilution technique. J Urol 108:373-376, 1972. 4. Immergut M, Plotkin A: Hemorrhage following needle biopsy of kidney. JAMA 211:827-828, 1970.Crossref 5. Karafin L, Kendall AR, Fleisher DS: Urologic complications in percutaneous renal biopsy in children. J Urol 103:332-335, 1970. 6. Sagar SJ, Kaye MB: Systemic infection following needle biopsy of the kidney. J Urol 109:930, 1973. 7. Fraser RA, Leary FJ: Ureterocutaneous fistula following percutaneous renal biopsy. J Urol 109:931-933, 1973. 8. Major T, Nolph KD: Calyceal-perirenal fistula and hydronephrosis complicating renal biopsy. J Urol 107:690-692, 1972. 9. Spong FW, Davis SL, Smith J: Calyceal-perirenal fistula: A transitory complication of percutaneous renal biopsy. Ann Intern Med 72:93-94, 1970.Crossref 10. Stern L, Langford C, Grossman BJ: Extravasation of urine: Radiologic demonstration following percutaneous renal biopsy. Am J Dis Child 119:88-90, 1970.Crossref 11. River GL, Dovenbarger WV, Nikolai TF: Unusual complications of kidney biopsy. J Urol 103:15-17, 1970.
Archives of Internal Medicine – American Medical Association
Published: Dec 1, 1975