Complications and monitoring of percutaneous renal biopsy - a retrospective study .

BACKGROUND AND AIMS: Percutaneous renal biopsy is a necessary tool to diagnose renal diseases but complications may still occur. The aims of this study were to detect the rate of complications, possible risk factors and to identify the necessity of routine post-biopsy controls at 4 - 6, and 24 hours.

MATERIALS AND METHODS: This single-center retrospective study included 500 consecutive biopsies of native and allograft kidneys performed at the Jena University Hospital.

RESULTS: Major complications occurred in 2.4% of all cases: 9 patients received blood transfusions (1.8%), 2 arterial-venous fistulas (0.4%), 1 angiographic intervention (0.2%), no surgical intervention or death. Minor complications after 24 (4 - 6) hours appeared in 31.8 (41.2)%: 14.8 (11.0)% had hematomas detected by ultrasound (n = 74), 17.0 (30.2)% a reduction of hemoglobin concentration ≥ 1.0 g/dL (n = 85), 4.8 (2.6)% both (n = 24), 1 macrohematuria (0.2%). Systolic blood pressure (≥ 155 mmHg vs. ≤ 126 mmHg, OR 2.007, 95% CI 1.003 - 4.018, p = 0.049) and younger age (per 1 year increase, OR 0.983, 95% CI 0.968 - 0.998, p = 0.027) were associated with the presence of hematoma. Baseline hemoglobin (per increase of 1.6 g/dL, OR 1.499, 95% CI 1.222 - 1.840, p < 0.001) and interstitial fibrosis (≥ 50% vs. ≤ 16%, OR 2.694, 95% CI 1.212 - 5.987, p = 0.015) influenced the finding of a persistent hemoglobin reduction ≥ 1.0 g/dL after 24 hours.

CONCLUSION: The complication rate after renal biopsy is low. Despite the lack of prospective data, our findings suggest that follow-up by a single blood count test combined with ultrasound examination at the day after renal biopsy would be sufficient, at least in the absence of explicit symptoms or risk factors for bleeding.
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