EXPLORING KIDNEY BIOPSY COMPLICATIONS: UNDERSTANDING RISK FACTORS AND HISTOLOGICAL CORRELATIONS
Dr SANDHYA SRINIVASAN1, Dr AIRIS TARYANA2, Dr CRAIG NEILSON2, Dr JULIAN CONBOY2, Dr MURTHY DIVI2, Dr KEN CHAU2
1Alice Springs Hospital, The Gap, Australia, 2Gold Coast University Hospital, Southport, Australia
Aim: To identify rates of percutaneous renal biopsy (PRB) complications of native and transplant kidneys performed at Gold Coast University Hospital. To identify an association of clinically significant complications with certain demographics, biochemistry, and histological lesions.
Background: PRBs are a vital tool utilized by nephrologists to diagnose and guide management. Quoted major complication rates for native PRBs range between 1.8% to 5%.
Methods: Retrospective medical record review of adult patient PRBs performed between January 2011 and December 2021.
Results: There were a total of 1259 biopsies with 1170 included in the final analysis. 161 (13.8%) individuals had biopsy complications with 56 (4.8%) individuals having clinically significant complication(s) which was defined as requiring intervention, prolonged hospital stay or readmission. No patient had nephrectomy or died due to a biopsy complication.
Biopsy complications were associated with a significantly higher mean serum creatinine (270 versus 237 µmol/L, p=0.02). Both females (15.9% females versus 12.3% males, p=0.08) and younger patients (54.8 versus 57.5 years, p=0.08) were more likely to experience biopsy complications.
We found no association between higher complication rates and pre-biopsy platelets, INR, and urea. There was no difference in complication rates between inpatient versus outpatient biopsies.
Membranoproliferative glomerulonephritis (MPGN), anti-glomerular basement membrane disease and hereditary glomerulopathy each had 20% complications rate. Both MPGN (20%, p=0.006) and lupus nephritis (12.5%, p=0.04) were associated with a significantly higher complications rate.
16.9% (n=137) had a prolonged hospital stay related to a biopsy related complication.
Conclusion: Biopsy complication rates in our center are similar to those quoted in the literature. Serum creatinine, female sex, younger age, MPGN and lupus nephritis histology are characteristics associated with increased biopsy complications.
Biography:
Sandhya is a first-year nephrology advanced trainee at Alice Springs Hospital. Hailing originally from Queensland, her passion and keen interest in rural healthcare, Aboriginal and Torres Strait Islander Peoples health, and outreach work has driven her to pursue her training in Central Australia. In her spare time, she enjoys exploring new places, hiking and spending time outdoors with her husband.