Percutaneous renal biopsy in the sitting position.

Percutaneous renal biopsy is now accepted as a useful diagnostic tool, with wvell-defined indications, risks, and limitations. Most commonly employed is the technique described by Kark and Muehrcke (1954) in which the patient lies prone across a sandbag throughout the procedure, so that the kidney is "fixed " against the posterior parietes and is therefore more easily entered by the biopsy needle. In a unit dealing with acute renal failure a diagnosis can, on occasion, be established early in the course of the disease only with the help of renal biopsy. We have found that acutely ill patients do not easily tolerate the prone position, but it has usually proved possible to obtain a biopsy with the patient sitting, supported if necessary. This technique was first described by Iversen and Brun (1951), and has been used by R. M. Kark and his associates (personal communication, 1960) in pregnant patients. Its adoption for routine use has not previously been described. A series of 164 consecutive renal biopsies taken in the sitting position is presented.