Frequency and Risk Factors of Ultrasound-Guided Kidney Biopsy Complications

Background: Kidney biopsy (KB) is the gold standard in the diagnosis of kidney diseases. Ultrasound (USG)-guided and automatic biopsy guns have decreased the complications. In our study, we examined the complications of KB performed using the routine kidney USG protocol performed during and 24 hours after the procedure. We also examined risk factors that may predict complications.

Methods: Major complications after biopsy were defined as bleeding requiring transfusion or surgical intervention. Minor complications were defined as hematoma not requiring transfusion, accompanied by hemoglobin (Hb) decrease of more than 1 g/dL. Ultrasound-guided automatic biopsy device and 18-gauge needle were used. Control USG was performed immediately after the biopsy and 24 hours after the procedure.

Results: Two hundred fifty-nine biopsy procedures were analyzed. Major complications were found in 15 (5.8%), minor complications in 22 (8.5%) patients. Of the 62 patients who developed hematoma after biopsy, 24 hematomas (38.7%) occurred immediately, and 38 hematomas (61.3%) were detected after 24 hours by the control USG. The low Hb and serological marker (antinuclear antibody, antineutrophil cytoplasmic antibody, and anti-glomerular basement membrane antibody) positivity were statistically significant in terms of major complications after KB.

Conclusion: Clinical follow-up for at least 24 hours, routine 24-hour control USG and early intervention (transfusion) may have prevented more severe clinical findings and complications. The low complication rate and the ability to obtain sufficient tissue make smaller-gauge needles advantageous. Low hemoglobin levels before biopsy and serological marker positivity were found to be independent risk factors for major complications.

Cite this article as: Demirelli B, Boynueğri B, Boztepe B, et al. Frequency and risk factors of ultrasound-guided kidney biopsy. Turk J Nephrol. 2024;33(3):252-258.