Do you apply manual pressure around the kidney biopsy site immediately post-procedure and prior to supine positioning to help prevent perinephric bleeding?  

Yes, I do apply 3-4 minutes of manual pressure immediately at the site of a kidney biopsy while the patient is prone or supine if doing a transplant biopsy. I also apply a pressure dressing and have the patient lie down on it for 2 hours (for native kidney biopsies). This helps in a thin person.

I only apply manual pressure at the kidney biopsy site if I see active bleeding after I remove the biopsy needle. This is mainly to stop bleeding from the needle tract. If there is no bleeding from the needle tract, I place a pressure dressing over the site prior to supine positioning of the patient...

No, I do not believe there is any benefit to applying pressure to the external skin or the back muscles. All such pressure will be absorbed by the skin, subcutaneous tissue, and muscle, and will not contribute to sealing the bleeding site on the posterior aspect of the kidney. It is advisable for th...