For outpatients undergoing a kidney biopsy, do you routinely recommend an overnight admission for continued hemoglobin monitoring?  

At our institution (The Ohio State University) and where I trained (Mount Sinai Hospital) where both IR and Nephrology perform outpatient renal biopsies, we do not routinely admit overnight. However, they are kept for monitoring for at least 4-6 hours and if the HgB is stable and the patient is asym...

If I perform an uneventful kidney biopsy in the morning on a patient with well-controlled BP and normal hemoglobin, I can observe the patient all day. If vitals are stable and the repeat hemoglobin at 8 hours is stable, I would discharge the patient. However, if I did the biopsy later in the day or ...

I see the value in close monitoring if the patient is a high risk of bleeding and/or unstable from other conditions. However - these patients should probably not be scheduled for outpatient biopsies in the first place. For my ambulatory, low-risk outpatients I do not recommend overnight admission o...

I think it is a good idea to admit overnight after a Kidney biopsy as complications can occur many hours after a biopsy. The 2004 JASN paper found: "Complications were identified in 38 (42%) patients by ≤4 h, in 61 (67%) patients by ≤8 h, in 77 (85%) patients by ≤12 h, and in 81 (89%) ...

Currently, at our hospital, we are not doing that. As far as I know, we have not had any adverse issues because of that. Having said that, I do think it is a good idea, as it is a safer thing to do. Significant bleeding events do occur after kidney biopsy. Usually, we are able to determine that with...

Patients with native or transplant kidney biopsies can easily be sent home after a period of a few hours observation. If patients are going to bleed, this usually happens relatively soon after the procedure. If vital signs are stable, there is no pain, the hemoglobin is stable, and there is not seve...