Delayed Bleeding as a Complication of Kidney Biopsy

Abstract

We report the case of a 60 years old female treated because of fluid lung under the presumption of acute oliguric renal failure in decompensated diabetic nephropathy with dialysis via a central venous line. Normal creatinine test results before admission were the reason for further diagnostics. Positive P-ANCA and Anti-MPO-Antibodies and the result of the renal biopsy proved the diagnosis of a renal limited microscopic polyangiitis. An immunosuppressive therapy with methylprednisolone and cyclophosphamide was initiated and a course of plasma exchange with substitution of ringer- albumin 5%- solution was started. Four days after biopsy a clinical deterioration occurred. The sonography image showed no clear result - an after that performed CT scan confirmed the diagnosis of an acute retroperitoneal bleeding. We recommend in these cases a partial or complete use of fresh frozen plasma as substitution fluid for plasma exchange and under suspicion of retroperitoneal bleeding a CT scan as the imaging modality of choice.




doi:10.4021/wjnu16w