When is renal biopsy mandatory vs deferrable?

Mandatory biopsy: unexplained AKI/CKD decline, nephrotic syndrome (except presumed minimal change in children), suspected systemic disease (vasculitis, lupus), and heavy proteinuria. Deferrable: known diabetic nephropathy with typical features.

What are contraindications to renal biopsy?

Absolute contraindications: uncontrolled hypertension, bleeding diathesis, single kidney (relative), small shrunken kidneys. Relative: antiplatelet/anticoagulant therapy (hold 5-7 days).

What complications can occur from renal biopsy?

Major complications: significant bleeding requiring transfusion or embolization (1-2%), inadvertent organ puncture (<0.1%). Minor: hematuria (10%), perinephric hematoma. Mortality <0.1%.

Renal Biopsy Indication vs Deferral Score

Determine renal biopsy indication vs safe deferral using clinical features: proteinuria >1 g/day, active urine sediment, unexplained eGFR decline, or systemic disease requiring diagnosis.

Use the full interactive calculator below, or

Renal Biopsy Indication vs Deferral Score

Frequently Asked Questions

When is renal biopsy mandatory vs deferrable?

What are contraindications to renal biopsy?

What complications can occur from renal biopsy?