A study of clinical complications and risk factors in 1,001 native and transplant kidney biopsies in Sweden.
BACKGROUND
In Sweden, native and transplant kidney biopsies are usually performed in major renal medical centers.


OBJECTIVE
To clarify risk factors in native and transplant kidney biopsies to improve patient safety.


METHODS
A total of 1001 biopsies (in 352 women and 565 men) were included. The median age was 54 years (range, 16-90 years). Data were derived from 826 native kidney biopsies (640 prospective and 186 retrospective) and 175 transplant kidney biopsies (170 prospective and 5 retrospective). Various factors and complications were registered while performing native and transplant kidney biopsies, focusing on major (e.g. blood transfusions, invasive procedures) and minor complications. The prospective protocol was used at six centers and at one center data were obtained retrospectively.


RESULTS
Women were at greater risk of overall complications than men (12.2% vs. 6.5%; P = 0.003; odds ratio [OR], 2.0; confidence interval [CI], 1.3-3.1) as well as of major complications (9.6% vs. 4.5%; P = 0.002; OR, 2.2, CI 1.3-3.7). Major complications occurred more commonly after biopsies from the right kidney, in women than in men (10.8% vs. 3.1%; P = 0.005; OR, 3.7; CI, 1.5-9.5), and in patients with lower BMI (25.5 vs. 27.3, P = 0.016) and of younger age (45 years vs. 52.5 years; P = 0.001). Lower mean arterial pressure in transplant kidney biopsies indicated a risk of major complications (90 mmHg vs. 98 mmHg; P = 0.039). Factors such as needle size, number of passes, serum creatinine, and eGFR did not influence complication rates.


CONCLUSIONS
The present findings motivate greater attention being paid to the risk of major side-effects after right-side biopsies from women's kidneys, as well as after biopsies from younger patients and patients with lower BMI.
Department of Nephrology, Skaraborg Hospital, Skövde, Sweden bjorn.peters@vgregion.se.
Björn
B
Peters
Department of Nephrology, Skaraborg Hospital, Skövde, Sweden.
Yvonne
Y
Andersson
Public Health and Clinical Medicine, Umeå University, Sweden.
Bernd
B
Stegmayr
Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Johan
J
Mölne
Department of Nephrology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Gert
G
Jensen
Medicine, Northern Älvsborg County Hospital, Trollhättan, Sweden.
Per
P
Dahlberg
Medicine, Southern Älvsborg Hospital, Borås, Sweden.
Inger
I
Holm-Gunnarsson
Transplantation Center, Sahlgrenska University Hospital, Gothenburg, Sweden.
Jana
J
Ekberg
Medicine, Halland Hospital, Halmstad, Sweden.
Karl
K
Bjurström
Department of Radiology, Skaraborg Hospital, Skövde, Sweden.
Stina-Britta
SB
Haux
Department of Nephrology, Skaraborg Hospital, Skövde, Sweden.
Henrik
H
Hadimeri
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000453:epidemiology*; D001707:Biopsy, Needle / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006417:Hematuria / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
Urinary; biopsy; complications; interventional; kidney; ultrasound