Histological diagnosis determines complications of percutaneous renal biopsy: a single-center experience in 353 patients.

Background: We studied the connection between complication occurrence related to renal biopsies and histological diagnoses of the biopsy specimen. We also analyzed the distribution of diagnoses in our population.

Methods: We retrospectively studied 353 patients undergoing renal biopsy at the same center. Biopsies were performed after marking the site of puncture by ultrasound imaging. Connection of complications with diagnoses and clinical parameters was evaluated.

Results: Complication rate was 44.5% in our study. There was a significantly lower rate of complications in patients with diabetic nephropathy (likelihood ratio, LR = 0.44) or acute tubular necrosis (LR = 0.38), while patients with thin basement membrane syndrome had a more than 6-fold higher risk for development of intrarenal hemorrhage than others. Patients with vasculitis (LR = 2.88) and acute interstitial nephritis (LR = 3.18) have a more than doubled risk for arteriovenous shunts, while in patients with severe arteriosclerosis the prevalence of this complication was lower (LR = 0.46). Arteriovenous shunts developed also at a significantly higher rate in patients with rapidly progressive glomerulonephritis.

Conclusion: Patients with thin basement membrane syndrome, vasculitis, rapidly progressive glomerulonephritis or acute interstitial nephritis should be observed more carefully after renal biopsy due to the significantly higher risk for certain complications.