Complications and Risks of Percutaneous Renal Biopsy

Lada Trajceska; Galina Severova-Andreevska; Pavlina Dzekova-Vidimliski; Igor Nikolov; Gjulsen Selim; Goce Spasovski; Irena Rambabova-Busljetik; Vesna Ristovska; Ladislava Grcevska; Aleksandar Sikole

doi:10.3889/oamjms.2019.226

Authors

Lada Trajceska University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Galina Severova-Andreevska University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Pavlina Dzekova-Vidimliski University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Igor Nikolov University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Gjulsen Selim University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Goce Spasovski University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Irena Rambabova-Busljetik University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Vesna Ristovska University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Ladislava Grcevska University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Aleksandar Sikole University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2019.226

Keywords:

Renal biopsy, Complications, Hematoma, Hematuria, Predictors

Abstract

BACKGROUND: Renal biopsy performed in native and transplant kidneys is generally considered a safe procedure.

AIM: In this study, we evaluated renal biopsy complications and risk factors in one nephrology facility.

MATERIAL AND METHODS: We conducted a three-year retrospective study on patients who underwent renal biopsy between January 2014 and December 2016. Strict written biopsy protocol was followed. Clinical and laboratory data were obtained from medical charts. Complications were categorised as minor and major, according to the need for intervention. Minor complications included macrohematuria and/or hematoma that did not require intervention. Major complications included hematuria or hematoma with fall of hematocrit that required a blood transfusion, surgery or caused death. A binary logistic regression model was used to analyse the possible factors associated with complications after the biopsy.

RESULTS: We analysed 345 biopsies; samples were taken from patients aged from 15-81 years, of whom 61% were men. A total of 21 (6%) patients developed a complication, 4.4% minor and 1.7% major complications. There were no nephrectomy or death due to biopsy intervention. Overweight patients, as well as those with higher creatinine, lower hemoglobin, higher blood pressure and biopsy due to AKI had higher chances to develop complications (p = 0.037, p = 0.023, p = 0.032, p = 0.002, p = 0.002, respectively). The patientsâ€™ age, gender, kidney dimension, number of passes and uninterrupted aspirin therapy were not found as significant predictors of complications. In the multivariate logistic model, body weight (OR = 1.031, 95%CI = 1.002-1.062), lower hemoglobin (OR = 0.973, 95%CI = 0.951â€“0.996) and hypertension (OR = 1.025, 95%CI = 1.007-1.044) increased the risk of complications in biopsied patients.

CONCLUSION: Renal biopsy is a safe procedure with a low risk of complications when strict biopsy protocol is observed. Correction of anaemia and blood pressure is to be considered before the biopsy.

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Author Biography

Aleksandar Sikole, University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia

Aleksandar Sikole graduated at the Medical Faculty-University "Sv. Kiril i Metodij" of Skopje, with MD degree in 1980. Specialized internal medicine in and subspecialized nephrology. Completed PhD thesis in 1994, entitled: â€œThe effect of erythropoietin therapy on the heart and bone marrow of end-stage renal disease patients on maintenance haemodialysisâ€. Since 2006 is Professor of Medicine at the Chair of Internal Medicine. He spent six months on postgraduate medical research at the Department of Nephrology of the University of Leiden , The Netherlands. In 2003 he had three months sabbatical at Laiko hospital, Athens, Greece. He was chief of hemodialysis unit at the Clinic of Nephrology and at present Director of the Clinic. Published and/or presented over 150 papers in national and international journals, books, and national and international congresses, symposia, proceedings etc. Involved in the organisation of several national and international congresses and symposia. Has conducted several clinical prospective multicentre studies in patients with chronic kidney disease. Was invited lecturer at several national and a few international meetings. Member of several medical and nephrological societies.

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