DIAGNOSTIC YIELD AND COMPLICATION RATE FOLLOWING PERCUTANEOUS RENAL BIOPSY

Abstract

Objective: To evaluate the diagnostic adequacy, safety, and complication rates of ultrasound-guided percutaneous renal biopsies performed with an 18-gauge automated biopsy needle in both native and transplanted kidneys.

Study Design: Prospective Longitudinal Study.

Study Setting: Department of Interventional Radiology, Shifa International Hospital, Islamabad, Pakistan.

Study Duration: November 2024 to April 2025.

Methodology: A total of 186 ultrasound-guided percutaneous renal biopsies (143 native, 43 transplant) were performed using an 18-gauge automated needle. Standardized protocols were followed for patient selection, pre-procedure preparation, the biopsy procedure itself, and post-procedural monitoring. Tissue adequacy and complications were recorded and analyzed.

Results: The mean patient age was 37.9 ± 16.7 years, with 62.9% being male. The mean number of glomeruli per biopsy was 12.9, exceeding the minimum required for diagnosis. Tissue adequacy was achieved in 100% of cases. The overall complication rate was low, with minor complications (e.g., small hematoma) observed in 13% of patients and a major complication rate of only 0.53%. No patient required blood transfusion, angiographic embolization, or nephrectomy. Complications were significantly more common in native kidney biopsies compared to transplant biopsies (23.1% vs. 0%, p < 0.001).

Conclusion: Ultrasound-guided percutaneous renal biopsy using an 18-gauge automated needle is a safe and highly effective diagnostic procedure. When performed by skilled operators with appropriate patient selection, it yields sufficient tissue for diagnosis with a very low incidence of complications for both native and transplant kidneys.