CEN Case Reports

, Volume 7, Issue 1, pp 9–12 | Cite as

Unexpected delayed bleeding after native renal biopsy: a case report

  • Yoichi Takeuchi
  • Yoshie Ojima
  • Saeko Kagaya
  • Satoshi Aoki
  • Tasuku Nagasawa
Case Report


Percutaneous native renal biopsy is recognized as a safe procedure. The majority of bleeding events occur within 24 h after the procedure, and reports of delayed major complications are very limited. We report a patient presenting with sudden flank pain 7 days after renal biopsy, in whom abdominal computed tomography showed increased hematoma size with extravasation and who was treated with radiological intervention. Careful attention should be paid to diagnose and treat delayed major complications in patients undergoing native renal biopsy.


Renal biopsy Complications Hematoma Intervention Guidelines 



We thank Dr. Takashi Hakamatsuka, a radiologist at our institute, for a fruitful discussion on the radiological intervention, and Keisuke Osamoto, a radiology technician at our institute, for accurate measurement of the hematoma volumes using imaging software.

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from the patient.


  1. 1.
    Whittier WL, Korbet SM. Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol. 2004;15:142–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Atwell TD, Spanbauer JC, McMenomy BP, Stockland AH, Hesley GK, Schleck CD, Harmsen WS, Welch TJ. The timing and presentation of major hemorrhage after 18,947 image-guided percutaneous biopsies. Am J Roentgenol. 2015;205:190–5.CrossRefGoogle Scholar
  3. 3.
    Maya ID, Allon M. Percutaneous renal biopsy: outpatient observation without hospitalization is safe. Semin Dial. 2009;22:458–61.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Hogan JJ, Mocanu M, Berns JS. The native kidney biopsy: update and evidence for best practice. Clin J Am Soc Nephrol. 2016;11:354–62.CrossRefPubMedGoogle Scholar
  5. 5.
    Tervaert TW, Mooyaart AL, Amann K, Cohen AH, Cook HT, Drachenberg CB, Ferrario F, Fogo AB, Haas M, de Heer E, Joh K, Noël LH, Radhakrishnan J, Seshan SV, Bajema IM, Bruijn JA. Renal Pathology Society. Pathologic classification of diabetic nephropathy. J Am Soc Nephrol. 2010;21:556–63.Google Scholar
  6. 6.
    Korbet SM. Nephrology and the percutaneous renal biopsy: a procedure in jeopardy of being lost along the way. Clin J Am Soc Nephrol. 2012;7:1545–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Tanaka K, Kitagawa M, Onishi A, Yamanari T, Ogawa-Akiyama A, Mise K, Inoue T, Morinaga H, Uchida HA, Sugiyama H, Wada J. Arterial stiffness is an independent risk factor for anemia after percutaneous native kidney biopsy. Kidney Blood Press Res. 2017;42:284–93.CrossRefPubMedGoogle Scholar
  8. 8.
    Ishikawa E, Nomura S, Hamaguchi T, Obe T, Inoue-Kiyohara M, Oosugi K, Katayama K, Ito M. Ultrasonography as a predictor of overt bleeding after renal biopsy. Clin Exp Nephrol. 2009;13:325–31.Google Scholar
  9. 9.
    Simard-Meilleur MC, Troyanov S, Roy L, Dalaire E, Brachemi S. Risk factors and timing of native kidney biopsy complications. Nephron Extra. 2014;4:42–9.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Nishi S. Series of guidebook of renal biopsy: IV. Prescription of bed-rest after renal biopsy. Nippon Jinzo Gakkai Shi. 2005;47:491–6. (Japanese).PubMedGoogle Scholar

Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  1. 1.Division of Nephrology, Department of MedicineJapanese Red Cross Ishinomaki HospitalIshinomakiJapan

Personalised recommendations