Complications of Percutaneous Renal Biopsy

Abstract

Percutaneous 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.

Retroperitoneal abscess with subcutaneous extension: case report of a rare complication of percutaneous renal biopsy

“…Similarly a retrospective analysis of 1832 renal biopsies over 37 years reported infections to affect only 0.2% of the biopsied patients [ 2 ]. Other prospective and retrospective data from databases have shown similar low incidence of perinephric abscesses (0.3%) [ 3 ]. In contrast, bacteraemia was shown to be commoner when renal biopsy was performed on those with pyelonephritis, affecting 6.2% of such patients [ 4 ].…”

A Systematic Review of Complications Associated With Percutaneous Native Kidney Biopsies in Adults in Low- and Middle-Income Countries

“…Thirty-nine articles 4,8,[15][16][17] were eligible for data extraction, reporting on 19,500 kidney biopsies performed on 19,338 patients in 18 countries located in six regions of the world (Figure 1 -Prisma flow chart). These regions include Sub-J o u r n a l P r e -p r o o f Saharan Africa (5 studies); 24,[27][28][29]52 South Asia (15 studies); 15,22,23,[30][31][32][33][34][35][36][37][38][39]54,55 Middle East and North Africa (7 studies); 8,17,25,26,[40][41][42] Latin America and Caribbean (2 studies); 50,51 Europe and Central Asia (3 studies); 48,49,53 and East Asia and Pacific (7 studies). 4,16,[44][45][46][47]56 There were 5 studies from low-income countries 15,[22][23]…”

“…4,16,[44][45][46][47]56 There were 5 studies from low-income countries 15,[22][23][24]55 ; 18 from lower middle-income countries 8,17,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]54 and 16 studies from upper middle-income countries. 4,16,[40][41][42][44][45][46][47][48][49][50][51][52][53]56 Based on quality assessment (with an interrater agreement of 79.4%), most studies (22/39; 56.4%) were moderate quality, 8,15,22,23,25,…”

“…The biopsy techniques using USS-RT were in 20 studies (48.8%), 4,15,16,24,31,32,34,[37][38][39][40][41]44,47,48,[50][51][52][53][54] USS-PM in 15 studies (36.6%), 8,15,16,22,23,27,33,35,36,42,45,46,49,55,56 one study (2.4%) was performed with fluoroscopic technique, 26 and 5 (12.2%) studies were performed with no imaging guidance (blind technique). 17,25,[28][29][30] In 11 studies, the biopsies were performed by nephrology staff (6 by nephrologists and another 5 by nephrology trainees), 15,16,22,34,51 it was performed by a nephrologist assisted by radiologists in 5 studies, 23,31,32,…”

“…17,25,[28][29][30] In 11 studies, the biopsies were performed by nephrology staff (6 by nephrologists and another 5 by nephrology trainees), 15,16,22,34,51 it was performed by a nephrologist assisted by radiologists in 5 studies, 23,31,32,50,55 and in 3 studies was performed by radiologists only. 38,41,52 However, twenty (51.4%) of the studies did not document the level of experience or specialty of the individuals performing the procedure 4,8,17,[24][25][26][27][28]30,33,35,36,43,[45][46][47][48][49]53,54 ( Table 1).…”