R HENRY GOODHEART1, A LUDWIG VAN WYK1, H PUTTAGUNTA1, R SWAMINATHAN1
1Fiona Stanley Hospital, Murdoch, Australia
Background: Biopsies are gold standard for assessment of renal disease, however, there is limited data regarding bleeding and complications associated with the procedure amongst Australian populations.
Methods: We retrospectively collected data of percutaneous native and transplant renal biopsies at our centre. Baseline demographics, indications, antiplatelet and anticoagulant use, pre-biopsy laboratory investigations, biopsy results and complications were collected. Complications were defined as any event which resulted in hospital admission, major complications were defined as those requiring transfusion or embolisation.
Results: 757 biopsies were performed, 386 (49%) of those native and 371 (51%) transplant kidneys. Complications included haematoma, haematuria, blood transfusion and embolisation.
Bleeding complications occurred in 30 procedures, at a rate of 3.96% (2.70% for transplant biopsies and 5.18% for native biopsies), and there were four major complications (0.53%). There was no statistically significant difference between complications in native and transplant biopsies (OR 1.97, 95% CI 0.91-4.27, P = 0.08). Higher pre-biopsy serum urea level (OR 1.082, 95% CI 1.01-1.16, P = 0.02) was associated with increased risk of bleeding complications. There was no significant association between bleeding complications and patient age, number of passes performed per biopsy, or pre-biopsy creatinine, haemoglobin, platelet count and coagulation profile results.
Conclusions: The rate of bleeding complications observed are comparable to those reported in international literature, highlighting that generally the procedure is safe, but not without risk. Future research may be required to establish validated pre-biopsy risk scoring tools to facilitate informed patient consent pre-procedure and improved decision-making.
Albert van Wyk completed his postgraduate Doctor of Medicine (MD) at the University of Australia in 2018. He currently works at Fiona Stanley Hospital, as a service registrar in Psychiatry, and has enrolled to undertake further training in general and rural medicine in the WA Country Health Service in 2021.
Richard Henry Goodheart completed his postgraduate Doctor of Medicine (MD) at the University of Australia in 2018. He is currently employed as a Resident Medical Officer at Fiona Stanley Hospital. He will continue on at this hospital in 2021 with the aim to enter Basic Physician’s Training there.
Aim: To retrospectively assess the rate and factors predicting complications of renal biopsies performed between February 2015 and February 2019 at our centre.