Incidence of renal biopsy complications in a 5-year follow up

Abstract

Perkutana biopsija bubrega (PBB) predstavlja zlatni standard u dijagnostici parenhimskih bolesti bubrega. Rutinski se obavlja pod ultrazvučnom (UZV) kontrolom, a u kompliciranijim slučajevima pod kontrolom MSCT uređaja. Kako je riječ o invazivnom postupku nad izrazito prokrvljenim organom moguć je razvoj komplikacija koje dijelimo u male (bez potrebe za transfuzijom krvi ili intervencijom), velike (potrebna transfuzija krvi ili intervencija) i katastrofalne (gubitak funkcionalne bubrežne mase, potreba za nefrektomijom, smrtni ishod). Cilj ovog istraživanja retrospektivna je analiza komplikacija svih biopsija bubrega učinjenih u Zavodu za nefrologiju KBC Zagreb u razdoblju 2015.-2019. godine. Tijekom navedenog razdoblja, učinjena je ukupno 201 biopsija nativnih (173 pod UZV i 28 uz MSCT kontrolu) i 339 presađenih bubrega (321 pod UZV i 18 uz MSCT kontrolu). U skupini bolesnika s bioptiranim nativnim bubrezima do razvoja malih postbioptičkih komplikacija došlo je u 28,4 % pacijenata, a 3,5 % je razvilo velike komplikacije. U skupini bolesnika s bioptiranim transplantiranim bubrezima male komplikacije razvilo je 10,6 % pacijenata, a velike komplikacije 0,6 % bolesnika. Katastrofalnih komplikacija nije bilo. PBB pokazala se sigurnom dijagnostičkom metodom s malom vjerojatnošću komplikacija čija je učestalost bila u skladu s podacima iz drugih velikih centara.Percutaneous renal biopsy (PRB) represents a gold standard procedure in diagnostics of parenchymal kidney diseases. Real-time ultrasound (US) serves as usual guidance method, while multislice computed tomography (MSCT) is used in more complicated cases. As every invasive procedure, kidney biopsy also poses risk for development of complications which are usually classified as minor, major and chatastrophic. The aim of this retrospective study was to analyze incidence and type of complications of PRB performed from 2015 till 2019 in Department of nephrology UHC Zagreb. Study included 540 patients who underwent PRB , (201 patients with native kidney PRB and 339 with transplanted organ PRB), under the US (173 native , 321 transplanted kidney) or MSCT guidance (28 native and 18 transplanted kidney PRB). Complications were divided into minor (no need for clinical intervention or blood transfusions), major (medical interventions or blood transfusion required) and catastrophic (functional kidney mass loss, nephrectomy, death). In the group of patients with PRB of native kidneys 28,4 % developed minor while 3,5 % major complications. In the transplanted kidney PRB group,10,6 % of patients developed minor while 0,6 % major complications. There were no catastrophic complications in either group. The rate of complications in our center was in line with the results from other experienced centers. PRB is a safe procedure with low complication risk