Percutaneous renal biopsy of ventilated intensive care unit patients

The etiology of acute renal failure in ventilated intensive care unit patients can be determined non-invasively in more than 80% of cases. When a pulmonary renal syndrome is suspected however it is important to obtain histological confirmation of the diagnosis prior to initiating therapy. Most text books and review articles have advocated the use of open surgical biopsy in this situation. Seven years ago we began to perform percutaneous renal biopsies on medical intensive care unit ventilated patients when a pulmonary renal syndrome was suspected as an alternative to an open surgical procedure. During this period we performed the technique on 7 patients. Adequate renal tissue was obtained in all cases. We compare the complication rate with that achieved using open surgical biopsy during the same time period. The complication rate using a percutaneous technique was similar to open renal biopsy. We believe that the previously held recommendation that percutaneous renal biopsy should not be performed on ventilated patients should be re-examined.