The Risks Associated With Percutaneous Native Kidney Biopsies (NKBs) in a Tertiary Care Hospital

Ikram Zeb  Khan; Farrukh  Islam; Samavia  Ijaz; Misbah  Farooq; Ashfaq  Altaf; Yasser  Khan

doi:10.54112/bcsrj.v6i4.1667

Authors

Ikram Zeb Khan Department of Nephrology, Armed Forces Institute of Urology Rawalpindi, Pakistan
Farrukh Islam Department of Nephrology, Armed Forces Institute of Urology Rawalpindi, Pakistan
Samavia Ijaz Department of Nephrology, Armed Forces Institute of Urology Rawalpindi, Pakistan
Misbah Farooq Department of Nephrology, Armed Forces Institute of Urology Rawalpindi, Pakistan
Ashfaq Altaf Department of Nephrology, Combined Military Hospital Quetta, Pakistan
Yasser Khan Department of Radiology, Combined Military Hospital Quetta, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i4.1667

Keywords:

Native kidney biopsy, complications, hematoma, blood transfusion

Abstract

Percutaneous native kidney biopsy (NKB) remains a cornerstone for the histopathological diagnosis of renal diseases. While it is generally considered a safe and effective procedure, the risk of complications—particularly bleeding—necessitates a careful evaluation of its safety profile in local healthcare settings. Objective: To assess the frequency and types of complications associated with percutaneous native kidney biopsies performed under real-time ultrasound guidance in a tertiary care center. Methods: This prospective observational study was conducted at a tertiary care hospital from September 2024 to March 2025. A total of 209 patients scheduled for percutaneous NKB were enrolled using non-probability consecutive sampling. Biopsies were performed under real-time ultrasound guidance using automated biopsy devices. Patients were monitored for complications up to 24 hours post-procedure. Complications were categorized as major (e.g., requirement for blood transfusion, angioembolization, prolonged hospitalization >24 hours, surgical intervention, or procedure-related death) or minor (e.g., self-limiting hematuria or small hematomas). Data were analyzed using SPSS Version 25, with descriptive statistics reported as frequencies and percentages. Results: The mean age of participants was 43.2 ± 16.5 years, and 119 (56.9%) were male. Minor complications were noted in 15 patients (7.1%), including small hematomas in 8 (3.8%) and transient hematuria in 7 (3.3%). Major complications occurred in 12 patients (5.7%). Of these, 5 (2.4%) required blood transfusion, 2 (0.9%) developed major hematomas, 2 (0.9%) experienced prolonged hospitalization, and 1 (0.5%) each required repeat biopsy or intervention due to inadequate specimens. No deaths were reported. Conclusion: Percutaneous NKB is a reliable and generally safe diagnostic procedure for renal pathology. Although minor complications such as transient bleeding are relatively common, serious adverse events remain infrequent. Continued adherence to real-time imaging and post-procedural monitoring protocols is recommended to further minimize risk.

Downloads

Download data is not yet available.

References

Kark RM, Muehrcke RC. Biopsy of kidney in prone position. Lancet (London, England). 1954;266(6821):1047-9.

Xu L, Bian X, Yang J, Xu H, Fang Y, Yang J, et al. Safety and effectiveness of laparoscopic renal biopsy: a single-center review and meta-analysis. Renal failure. 2024;46(1):2312536.

Granata A, Distefano G, Pesce F, Battaglia Y, Suavo Bulzis P, Venturini M, et al. Performing an Ultrasound-Guided Percutaneous Needle Kidney Biopsy: An Up-To-Date Procedural Review. Diagnostics (Basel, Switzerland). 2021;11(12).

Schnuelle P. Renal Biopsy for Diagnosis in Kidney Disease: Indication, Technique, and Safety. Journal of clinical medicine. 2023;12(19).

Poggio ED, McClelland RL, Blank KN, Hansen S, Bansal S, Bomback AS, et al. Systematic Review and Meta-Analysis of Native Kidney Biopsy Complications. Clinical journal of the American Society of Nephrology : CJASN. 2020;15(11):1595-602.

Gal-Oz A, Papushado A, Kirgner I, Meirsdorf S, Schwartz D, Schwartz IF, et al. Thromboelastography versus bleeding time for risk of bleeding post native kidney biopsy. Renal failure. 2020;42(1):10-8.

Bux KI, Moorani KN, Qureshi H, Kumari U, Khan F, Farooq F, et al. Safety and Adequacy of Ultrasound-Guided Percutaneous Renal Biopsy in Children: A Single-Center Experience. Cureus. 2022;14(4):e24452.

Andrulli S, Rossini M, Gigliotti G, La Manna G, Feriozzi S, Aucella F, et al. The risks associated with percutaneous native kidney biopsies: a prospective study. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2023;38(3):655-63.

Xu S, Ma L, Lin J, Zhang Z, Wang X, Yin J. Efficacy and safety of percutaneous renal biopsy performed using 18G needle versus 16G needle: a single-center retrospective study. International urology and nephrology. 2022;54(12):3255-61.

Pokhrel A, Agrawal RK, Baral A, Rajbhandari A, Hada R. Percutaneous Renal Biopsy: Comparison of Blind and Real-time Ultrasound Guided Technique. Journal of Nepal Health Research Council. 2018;16(1):66-72.

Kajawo S, Ekrikpo U, Moloi MW, Noubiap JJ, Osman MA, Okpechi-Samuel US, et al. A Systematic Review of Complications Associated With Percutaneous Native Kidney Biopsies in Adults in Low- and Middle-Income Countries. Kidney international reports. 2021;6(1):78-90.

Azhar A, Anwar N, Zeb A, Amin UJJ-JoPMI. Renal biopsy: An effective and safe diagnostic procedure. 2006;20(1):78-81.

Prakash J, Singh M, Tripathi K, Rai US. Complications of percutaneous renal biopsy. Journal of the Indian Medical Association. 1994;92(12):395-6.

Corapi KM, Chen JL, Balk EM, Gordon CE. Bleeding complications of native kidney biopsy: a systematic review and meta-analysis. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2012;60(1):62-73.

Mishra A, Tarsin R, ElHabbash B, Zagan N, Markus R, Drebeka S, et al. Percutaneous ultrasound-guided renal biopsy. 2011;22(4):746-50.

Jiang SH, Karpe KM, Talaulikar GS. Safety and predictors of complications of renal biopsy in the outpatient setting. Clinical nephrology. 2011;76(6):464-9.

Whittier WL, Korbet SM. Timing of complications in percutaneous renal biopsy. Journal of the American Society of Nephrology : JASN. 2004;15(1):142-7.

Toledo K, Pérez MJ, Espinosa M, Gómez J, López M, Redondo D, et al. [Complications associated with percutaneous renal biopsy in Spain, 50 years later]. Nefrologia. 2010;30(5):539-43.