Journal de néphrologie et thérapeutique

Perinephric Hematoma Following Renal Biopsy: A Case Report and Literature Review

Abstract

Girish P Vakrani *,Nambakam Tanuja Subramanyam ,Hareesh Babu

Background: The risks associated with performing a percutaneous renal biopsy have substantially decreased in the past two decades because of technical advances in the method. However, bleeding complications still occur, resulting in increased hospital stay, treatment costs and even mortality.
Objective: The purpose of this case reporting is to discuss about life threatening complication like perinephric hematoma following a renal biopsy in a high risk patient with severe renal failure.
Methods: The clinical, radiological findings, prognosis of a massive perinephric hematoma following a renal biopsy in a high risk patient with severe renal failure are discussed.
Results: We report a case of 39 year old, male, non-diabetic, hypertensive since 5 years who presented with unexplained severe renal failure. After dialyzing adequately, he was subjected to right renal biopsy using real time ultrasound guided automated renal biopsy gun. Post biopsy was uneventful, until 72 hours when he developed massive right perinephric hematoma following a heparin-free hemodialysis. He continued to be hypotensive despite hemostatics, blood products, and plasma expander transfusion. Unfortunately, he expired before definitive management like renal angiogram and intervention was attempted.
Conclusions: To the best of our knowledge, this is one of few reports of the occurrence of life threatening
complication like perinephric hematoma in a patient with severe renal failure on heparin free  hemodialysis 72 hours following a renal biopsy.