Incidence and Determinants of Complications of Percutaneous Kidney Biopsy in a Large Cohort of Native Kidney and Kidney Transplant Recipients

Abstract

Objectives: This study aimed to determine the incidence and factors associated with complications for kidney biopsy. Percutaneous kidney biopsy is a useful diagnostic procedure. Haemorrhagic complications may occur following the procedure. Methods: The present study retrospectively analysed the records of patients who had percutaneous renal biopsy between March 2013 and March 2018. The cohort included both native kidney and native transplant biopsies. We have included only the first biopsy for each patient; repeat biopsies were excluded from the analysis. Results: A total of 1,198 patients (332 transplant recipients and 886 native kidney patients) were included in this study. Major complications occurred in 1.5% (n = 18) of patients (1.4% in native kidney biopsies versus 1.6% in kidney transplant recipients). Adequate renal tissue (core of >6 glomeruli) was obtained in 91% of the patients. Data analysis revealed that the incidence of major complications in the native kidney biopsy increase with an age >65 years (odds ratio = 2.4; 95% Confidence interval [CI] = 1.5–5.6), estimated glomerular filtration rate (eGFR) <30 mL/min/m2 (odds ratio = 9.7; 95% CI = 3.4–18.2) and anaemia (odds ratio = 3.2; 95% CI = 1.7–5.2). In transplant recipients kidney biopsy, the incidence of complications was increased with age >65 years (odds ratio = 2.8; 95% CI = 1.7–7.3), eGFR <30 mL/min/m2 (odds ratio = 11.3; 95% CI = 3.5–16.8) and anaemia (odds ratio = 2.4; 95% CI = 1.4–4.7). Conclusion: The incidence of major complications following kidney biopsy was 1.5% for a cohort of native kidney biopsy and kidney transplant biopsies. Age >65 years, lower eGFR <30 mL/min/m2 and anaemia were independent risk predictors for the occurrence of major complications in both native and transplant kidney biopsies.

Keywords: Biopsy; Biopsy, Needle; Complications; Safety; Kidney.