title: Percutaneous renal biopsy of native kidneys: a single-center experience of 1,055 biopsies.
abstract: BACKGROUND
  Percutaneous renal biopsy (PRB) of native kidneys is an essential tool in the diagnosis and management of renal disease. We report one of the largest single-center experiences on the success and safety of the procedure.
  
  
  METHODS
  From June 1983 to March 2012, 1,055 adults underwent PRB using real-time ultrasound guidance and 14-gauge biopsy needles. Data were collected prospectively for 826 biopsies (78%). Statistical analysis was performed using the Mann-Whitney test, Wilcoxon matched pairs test and Kruskal-Wallis test for continuous data or the Fisher's exact test and χ(2) test for categorical data. Multivariate analysis using logistic regression was performed to determine which feature at baseline was predictive of a complication following renal biopsy.
  
  
  RESULTS
  Patients were aged 46 ± 17 years; 38% were male, 40% were white and 43% were African-American. Serum creatinine (SCr) was 2.3 ± 2.3 mg/dl (>1.5 mg/dl in 47%). The pre-PRB hemoglobin was 12 ± 2 g/dl (<11.0 g/dl in 35%). Adequate tissue for diagnosis was obtained in 99% of biopsies. Minor complications occurred in 8.1% of biopsies (mainly gross hematuria, in 4.5%). Major complications occurred in 6.6% of biopsies, with transfusions required in 5.3%. Only 1 death (0.09%) resulted from post-PRB bleeding. By multivariate analysis, baseline features predictive of a complication were systolic blood pressure >170 mm Hg (OR 4.2, 95% CI 1.8-9.8), bleeding time >7.5 min (OR 1.7, CI 1.2-2.5) and SCr >3.5 mg/dl (OR 1.8, CI 1.2-2.9).
  
  
  CONCLUSIONS
  PRB of native kidneys using real-time ultrasound with a 14-gauge automated needle remains a successful and safe procedure.
authors: Section of Nephrology, Department of Medicine, Rush University Medical Center, Chicago, Ill., USA.
authors: Stephen M
authors: SM
authors: Korbet
authors: Kaelin C
authors: KC
authors: Volpini
authors: William L
authors: WL
authors: Whittier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006417:Hematuria / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods; D055815:Young Adult