Percutaneous renal biopsies are low-risk procedures for patients regardless of age, researchers concluded.
In study of 9,288 renal biopsies performed on 715 children and 8,573 adults (aged 18 years and older), a team led by Camilla Tøndel, MD, of Haukeland University Hospital in Bergen, Norway, found a less than 1% overall rate of complications, defined as gross hematuria, a need for blood transfusion, or a need for surgical intervention or catheterization. These complications occurred in 1.9%, 0.9%, and 0.2% of patients, respectively. The frequencies were 1.7%, 0.1%, and 0.1% in children and 1.9 %, 0.9%, and 0.2% in adults, respectively, the investigators reported online ahead of print in the Clinical Journal of the American Society of Nephrology.
The study, which analyzed data from the Norwegian Kidney Biopsy Registry, showed that 97.9% of the biopsies occurred without complications. In adjusted analyses, smaller clinical centers and low estimated glomerular filtration rate were associated with an increased likelihood of major complications, defined as blood transfusion or surgical intervention or catheterization.
The general safety and complication rate of the procedure has substantially improved as a result of technical advances in imaging diagnostics and biopsy procedure, the investigators stated. Post-biopsy hematoma is relatively common, and may not be regarded as a complication when not followed by transfusion or intervention.
“To our knowledge,” the authors wrote, “the current study is the only nationwide registry-based and largest report of renal biopsy complications, and our findings confirm the general impression of low complication rates and improved safety of modern renal biopsy procedures.”
In an accompanying editorial, Stephen M. Korbet, MD, of the Section of Nephrology at Rush University Medical Center in Chicago, pointed to a decline in the performance of percutaneous renal biopsies by nephrologists, a trend that “should be alarming to all of us and especially to those of us who are involved with training fellows. As nephrologists, we have a vested interest in the biopsies we perform that is not shared by radiologists, because the information provided by this procedure directly affects the care we provide to our patients.”