Percutaneous renal biopsies and hemorrhage in multiple myeloma.

Renal biopsy is commonly done in patients with increased bleeding risks due to chronic renal disease or multiple myeloma, (MM). Multiple myeloma causes renal impairment by amyloid deposition and immunoglobulin deposition, and it also can be the effect of the MM therapies. Renal biopsy is required to differentiate between these processes. Biopsy procedures are associated with increased risk of bleeding since MM therapy often causes thrombocytopenia and anemia. In addition, MM elevates bleeding risk by unique derangements of hemostasis associated with B-cell disorders. Excessive MM bleeding can be due to: – Low Factor VIII, IX, X and/or vitamin K function – Intravascular coagulopathy – Amyloid deposition, which makes tissues fragile – Compromised fi brin function