Introduction: Ultrasound-guided non-focal renal biopsy (USNFRB) is a well-accepted procedure performed in the renal cortex to investigate medical renal disease or renal transplant rejection.
Objectives: The purpose of this study was to identify the hemorrhagic complication rate for a large cohort of patients after radiologist-performed USNFRB and to identify risk factors.
Patients and Methods: For this Institutional Review Board-approved retrospective review, all patients who underwent USNFRB from January 2001 to September 2012 were identified using a departmental database, and reviewed the electronic chart for demographics, laboratory workup, medications, procedural details, and complications. The impact of these variables on the likelihood of having a bleeding complication that either did (major) or did not (minor) require further intervention was assessed, using Fisher exact and Student’s t tests, and multiple logistic regression.
Results: Of 570 USNFRBs performed by radiologists, 26 (4.6%) resulted in hemorrhagic complications, 15 of which were major and 11 minor. Neither age, gender, race, nor size of biopsy needle differed among patients with and without bleeding complications (P > 0.05). When assessing the impact of coagulation and renal function laboratory measures, low estimated glomerular filtration rate (eGFR) was the strongest predictor of bleeding complication (P = 0.03).
Conclusion: USNFRB is a relatively safe procedure, with less than 5% resulting in bleeding complications. Low eGFR is the strongest predictor of hemorrhagic complication, and is likely the most helpful variable in triaging patients during pre-procedure workup.