Percutaneous renal biopsy of native kidneys: efficiency, safety and risk factors associated with major complications

Introduction: Percutaneous renal biopsy (PRB) of native kidneys is an important tool for diagnosis and management of renal disease. In this study, we analyzed the success, safety, and risk complications of PRB in our center. Methods: A retrospective review of ultrasound-guided PRB done at our institution from January 1998 to December 2017 was performed. Clinical and laboratory data were collected for 661 PRBs. Statistical analysis was performed using the Mann-Whitney U test for continuous variable and chi-square test for categorical variables. Multivariate analysis using logistic regression was performed to assess factors associated with increased risk of complications after PRB. Results: The median age was 56 (42–68) years old, the majority were male (64%) and white (82%). Ten glomeruli were present in 63.5% of PRBs. Overall, the rate of complications was 16.6%, where 15.1% of them were minor complications and 1.5% were major complications. Perinephritic hematoma accounted for the minor complication that occurred most frequently, whereas the need of a blood transfusion was the prevalent for major complications. By multivariate analysis, increased activated partial thromboplastin time (aPTT; OR 1.11, 95% CI 1.035–1.180) and prebiopsy lower hemoglobin (Hgb; OR 1.61, 95% CI 1.086–2.304) were identified as independent risk factors for major complications. In addition, older patients (OR 1.057, 95% CI 1.001–1.117) were identified as an independent risk factor for blood transfusion requirement. Conclusion: The current risk of complications after native PRB is low. Major complications are most common in case of increased aPTT and decreased Hgb baseline level.

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Life-Threatening Complications Following Percutaneous Ultrasound-Guided Renal Biopsy: a Rare Case Report

International Archives of Medicine ◽

10.3823/2292 ◽

2017 ◽

Vol 10 ◽

Cited By ~ 1

Author(s):

Yuan-Hung Lo ◽

Po-Jen Hsiao ◽

Szu-Han Chiu ◽

Kun-Lin Wu ◽

Che-Fu Chang ◽

...

Keyword(s):

Renal Biopsy ◽

Hypovolemic Shock ◽

Bleeding Complications ◽

Ultrasound Guided ◽

Basic Tool ◽

Gross Hematuria ◽

Percutaneous Renal Biopsy ◽

Major Complications ◽

Rare Case Report ◽

Life Threatening

Ultrasound-guided percutaneous renal biopsy has been a basic tool for the diagnosis of kidney disease, but minor and major complications cannot be completely avoided. Major complications including gross hematuria, renal hematoma and arteriovenous fistula, and usually develop within 24 hours after renal biopsy. We present an educational case of female having major bleeding complications after renal biopsy with unusual clinical courses. The patient developed hypovolemic shock at 48 hours after renal biopsy along with perirenal hematoma and hemothorax. The case highlight the need to remain the major complications in mind for physicians. Key words: Hemothorax, renal biopsy.

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Complications of Percutaneous Renal Biopsy

Seminars in Interventional Radiology ◽

10.1055/s-0039-1688422 ◽

2019 ◽

Vol 36 (02) ◽

pp. 097-103

Author(s):

Kenaz Bakdash ◽

Kristofer M. Schramm ◽

Aparna Annam ◽

Matthew Brown ◽

Kimi Kondo ◽

...

Keyword(s):

Risk Factors ◽

Renal Biopsy ◽

Bleeding Complications ◽

Modifiable Risk Factors ◽

Delayed Presentation ◽

Histologic Diagnosis ◽

Poor Renal Function ◽

Percutaneous Renal Biopsy ◽

Risk Patients

AbstractPercutaneous renal biopsy is widely used for diagnosis, prognosis, and management of nephropathies. Complications may arise after renal biopsy, most commonly in the form of bleeding. Efforts should be taken to optimize modifiable risk factors such as hypertension, thrombocytopenia, and coagulopathy prior to the procedure. Unmodifiable risk factors such as poor renal function, gender, and underlying histologic diagnosis may be used to identify high-risk patients. Delayed presentation of bleeding complications is common, and close clinical follow-up is crucial.

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Risk factors for bleeding complications in percutaneous renal biopsy

Clinical and Experimental Nephrology ◽

10.1007/s10157-004-0326-7 ◽

2005 ◽

Vol 9 (1) ◽

pp. 40-45 ◽

Cited By ~ 110

Author(s):

Masaaki Eiro ◽

Tetsuo Katoh ◽

Tsuyoshi Watanabe

Keyword(s):

Risk Factors ◽

Renal Biopsy ◽

Bleeding Complications ◽

Percutaneous Renal Biopsy

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Risk Factors for Severe Bleeding Complications in Percutaneous Renal Biopsy

The American Journal of the Medical Sciences ◽

10.1016/j.amjms.2016.12.019 ◽

2017 ◽

Vol 353 (3) ◽

pp. 230-235 ◽

Cited By ~ 19

Author(s):

Da-min Xu ◽

Min Chen ◽

Fu-de Zhou ◽

Ming-hui Zhao

Keyword(s):

Risk Factors ◽

Renal Biopsy ◽

Bleeding Complications ◽

Severe Bleeding ◽

Percutaneous Renal Biopsy

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A simple scoring system for predicting early major complications in spine surgery: the cumulative effect of age and size of surgery

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160127 ◽

2016 ◽

Vol 74 (10) ◽

pp. 803-809 ◽

Cited By ~ 2

Author(s):

Albert Vincent Berthier Brasil ◽

Alisson R. Teles ◽

Marcelo Ricardo Roxo ◽

Marcelo Neutzling Schuster ◽

Eduardo Ballverdu Zauk ◽

...

Keyword(s):

Risk Factors ◽

Spine Surgery ◽

Scoring System ◽

Cumulative Effect ◽

Patient Counseling ◽

Factors Associated ◽

Major Complications ◽

Postoperative Spine ◽

Independent Risk Factors ◽

Effect Of Age

ABSTRACT Objective To analyze the cumulative effect of risk factors associated with early major complications in postoperative spine surgery. Methods Retrospective analysis of 583 surgically-treated patients. Early “major” complications were defined as those that may lead to permanent detrimental effects or require further significant intervention. A balanced risk score was built using multiple logistic regression. Results Ninety-two early major complications occurred in 76 patients (13%). Age > 60 years and surgery of three or more levels proved to be significant independent risk factors in the multivariate analysis. The balanced scoring system was defined as: 0 points (no risk factor), 2 points (1 factor) or 4 points (2 factors). The incidence of early major complications in each category was 7% (0 points), 15% (2 points) and 29% (4 points) respectively. Conclusions This balanced scoring system, based on two risk factors, represents an important tool for both surgical indication and for patient counseling before surgery.

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Predictors of perirenal haematoma post-percutaneous ultrasound-guided renal biopsy

Journal of International Medical Research ◽

10.1177/03000605211058377 ◽

2021 ◽

Vol 49 (11) ◽

pp. 030006052110583

Author(s):

Shihao Xu ◽

Bing Xiong ◽

Saifeng Lin ◽

Qiao Li ◽

Lei Wang ◽

...

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Renal Biopsy ◽

Real Time ◽

Binary Logistic Regression ◽

Binary Logistic Regression Analysis ◽

Ultrasound Guided ◽

Factors Associated ◽

A Prospective Study ◽

Haematoma Formation

Objective To perform a prospective study to determine the risk factors associated with perirenal haematoma development after percutaneous renal biopsy (PRB). Methods This multivariate prospective study collected demographic and clinical data from all consecutive adult patients that underwent real-time ultrasound-guided PRB of native kidneys. All biopsies were performed by two well-trained ultrasound physicians using 16G biopsy needles. Routine renal ultrasounds were performed within 12–24 h after biopsies in order to observe post-biopsy perirenal haematoma formation. Patients were stratified based on the occurrence of post-biopsy haematoma development. Results This prospective study enrolled 218 patients and stratified them into a haematoma group ( n = 126) and a non-haematoma group ( n = 92). Binary logistic regression analysis identified female patients (odds ratio [OR] 1.990; 95% confidence interval [CI] 1.125, 3.521), patients with a body mass index (BMI) ≥28 kg/m2 (OR 2.660; 95% CI 1.097, 6.449) and patients with immediate post-biopsy active bleeding (IPAB) (OR 2.572; 95% CI 1.422, 4.655) as being more likely to have perirenal haematoma after real-time ultrasound guided PRB of native kidneys. Conclusion Female sex, a BMI ≥28 kg/m2 and IPAB were risk factors for perirenal haematoma after real-time ultrasound-guided PRB of native kidneys.

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