Renal infarction and rapidly progressive arterial thromboembolism following a percutaneous renal biopsy

A percutaneous renal biopsy is the diagnostic procedure of choice in a variety of renal diseases. Although the risk is generally minimal, serious complications can rarely occur. Here we present the case of a 50-year-old male with renal amyloidosis due to myeloma, who suddenly developed left flank pain after a percutaneous renal biopsy. Imaging studies revealed a renal infarction with an intraluminal thrombus in the left wall of the descending aorta. Subsequent arterial thromboembolic events in the left limb followed immediately after the femoral arteriography. Arterial thromboembolism is a relatively rare, serious, unexpected and multifactorial event that occurs during an exacerbation of the nephrotic syndrome. In this case, the arterial vascular trauma from the renal biopsy and arterial puncture for angiography might have increased the risk for the thrombotic episode that resulted in death. Therefore, a thorough assessment for the risk factors prior to an invasive procedure such as a renal biopsy should be required so that patients at high risk can be identified.