Perinephric hematoma following renal biopsy: A case report and literature review

Abstract

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. The purpose of this case report is to discuss the life threatening complications like perinephric hematoma following a renal biopsy in a high risk patient with severe renal failure. 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. 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 h when he developed massive right perinephric hematoma following a heparin-free hemodialysis. He continued to be hypotensive despite hemostatics, blood products, plasma expander transfusion. Unfortunately, he expired before definitive management like renal angiogram and intervention was attempted. 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 following a renal biopsy after 72 h.