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August 9, 1971

Retrograde Catheter Localization for Percutaneous Renal Biopsy

Author Affiliations

Los Angeles

JAMA. 1971;217(6):824. doi:10.1001/jama.1971.03190060062018

To the Editor. —  Renal biopsy is often required to establish diagnosis and prognosis in the patient with acute or chronic renal disease. Selective localization of the renal cortex is often difficult, and an insufficient specimen may be obtained.1,2 Infusion pyelography with fluoroscopy2 has gained widespread acceptance but is not feasible in the acutely or severely anuric or severely uremic patient whose kidney function is inadequate to localize the contrast medium. Arteriography carries an additional morbidity risk factor if not otherwise clinically indicated.3 Both of these procedures are also contraindicated in the patient allergic to organic iodides. Retroperitoneal air insufflation like-wise4 has an associated morbidity factor and does not otherwise contribute to the evaluation.Retrograde pyelography may be required for localization and to exclude obstructive disease when kidney and collecting systems are not visualized with high-dose excretory pyelography. A renal biopsy may be easily performed with