Ramaswamy Rajesh MBBS, MRCS, Presenter: Nothing to Disclose

Shueh Hao Lim MBChB, Abstract Co-Author: Nothing to Disclose

Robert Hunter, Abstract Co-Author: Nothing to Disclose

Fiona Gifford, Abstract Co-Author: Nothing to Disclose

Judith Margaret Anderson MD, Abstract Co-Author: Nothing to Disclose

Caroline Whitworth, Abstract Co-Author: Nothing to Disclose

Christopher Bellamy, Abstract Co-Author: Nothing to Disclose

Paul Lindsay Allan MD, Abstract Co-Author: Nothing to Disclose

Dilip Kumar Patel MBBS, Abstract Co-Author: Nothing to Disclose

To determine the complication and diagnostic yield rates of ultrasound guided native and transplant kidney biopsies over a 5-year period.

Retrospective analysis of 832 biopsies performed in 735 patients who underwent ultrasound guided diagnostic renal biopsies between January 2008 and October 2012 in our institution were identified and analysed from the hospital renal and pathology data bases. Chi-square and Mann Whitney test were used and significance set at <0.05.

 A total of 832 biopsies were performed in 735 patients. 314(38%) biopsies were performed as emergency procedures and 518(62%) as elective. The median age of the study group was 54 years (range 10 to 90 years) and M: F ratio 57:43. The overall complication rate was 6.7% (1.3% major and 5.4% minor). The major complication rate in the emergency biopsy group was significantly higher compared to the elective group (2.5% vs 0.8%; p=0.04). Renal function was significantly worse in the major complication group (creatinine 457 umol/l vs 201umol/l, p=0.01). All 11 patients who sustained major haemorrhage received a blood transfusion and 8 underwent emergency arterial embolisation. The risk of major haemorrhage was higher in the transplant compared to native group (2.2% vs 1.0%; p= 0.25). No coagulation profile difference was noted between the major and minor complication groups. No difference was noted in the minor complication rate between the native and transplant groups. In the 30-day periprocedural period there were 2 deaths unrelated to the procedure. Overall diagnostic yield rate was 95.1%, with an average of 12.3 glomeruli in the formalin sample. In the non-diagnostic sample group (4.9%), the average number of glomeruli in the formalin sample was lower at 1.3 glomeruli. No difference was observed between the native and transplant group yield rates.  

The complication rate of our cohort group compares favourably with those quoted in the published literature. The major complication rate was significantly higher in the group who underwent biopsy as an emergency procedure, in patients with significantly impaired renal function and in the transplant patient group. There were no biopsy related kidney losses or deaths.

Ultrasound guided diagnostic renal biopsy is a safe procedure with a high diagnostic yield.

Rajesh, R, Lim, S, Hunter, R, Gifford, F, Anderson, J, Whitworth, C, Bellamy, C, Allan, P, Patel, D, Complication and Diagnostic Yield Rates of Ultrasound Guided Renal Biopsies: A Retrospective Review of 832 Biopsies Performed at a Tertiary Referral Institution.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045549.html