A retrospective analysis of complication and adequacy rates of ultrasound-guided native and transplant non-focal renal biopsies.

Abstract

To assess non-focal ultrasound (US)-guided renal biopsy complication and adequacy rates at our institution. A retrospective analysis of 1067 non-focal renal biopsy cases between 2012 and 2015. Information collected including type of US-guided procedure (US-localized by nephrology vs. real-time US-guided by radiology), sample adequacy, complications, blood work, and histologic data. 602 biopsies were performed by radiology (56.4%) and 465 (43.6%) by nephrology. The overall adequacy rate was 96.1%, with an US-localized rate of 95.7% and real-time US-guided rate of 96.3% (p=0.58). A lower adequacy rate was noted for 1 biopsy core but there were no differences between 2 and 6 cores (p=0.001). A lower adequacy rate was found for transplant biopsies vs. native biopsies (p=0.03). Complication rates were as follows-minor 5.9%, major 4.3%, and life-threatening 0.8%. There were no differences in complication rates between the US-localized and real-time US-guided techniques (p=0.63). Complications were more likely in patients with a lower hemoglobin, higher serum creatinine, and lower albumin (p<0.05). No differences were found between the number of cores performed and the complication rates. The complication rate was similar between transplant biopsies vs. native biopsies (p=0.2). The adequacy rate was lower in trainees (p=0.01) than experienced radiologists. No significant differences were found between US-localized vs. real-time US-guided techniques. A lower adequacy rate was found for trainee radiologists and for transplant biopsies. A lower adequacy rate wasalso observed when only 1 biopsy pass was performed.