Indications for percutaneous needle biopsy include
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Unexplained acute renal failure or chronic renal insufficiency;
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Acute nephritic syndromes;
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Unexplained proteinuria and hematuria;
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Previously identified and treated lesions to plan future therapy;
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Systemic diseases associated with kidney dysfunction, such as systemic lupus erythematosus (SLE), Goodpasture's syndrome, and Wegener's granulomatosis, to confirm the extent of renal involvement and to guide management;
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Suspected transplant rejection, to differentiate it from other causes of acute renal failure; and
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To guide treatment.
Relative contraindications include a solitary or ectopic kidney (exception: transplant allografts), horseshoe kidney, uncorrected bleeding disorder, severe uncontrolled hypertension, renal infection, renal neoplasm, hydronephrosis, end-stage renal disease (ESRD), congenital anomalies, multiple cysts, or uncooperative patient.
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