Bleeding Complications and Insufficient Samples after Percutaneous Native Kidney Biopsy

Introduction: Insufficient samples in kidney biopsies (total number of glomeruli ≤7) significantly impact diagnostic accuracy. Recently, the rate of inadequate kidney biopsy samples in the United States has risen to 14%, posing a substantial issue. This study analyzes the frequency and influencing factors of inadequate samples and bleeding in kidney biopsies at our institution. Case Description: This retrospective study included 70 cases of kidney biopsies performed between August 2022 and March 2023. Variables analyzed included the presence of insufficient samples, bleeding events, age, gender, height, weight, eGFR, position, laterality, and number of punctures. The results are presented as medians (IQR). Among the patients, 36 were male (52%), with a median age of 56 years (45-68), BMI of 22 kg/m2 (22-24), and eGFR of 57 ml/min/1.73m2 (39-72). There were 11 cases (16%) of left kidney biopsies, 2 cases (2.9%) performed in the lateral position, with a median of 5 punctures (4-6), 3 biopsy cores obtained (2-4), and 33 glomeruli collected (22-42). Insufficient samples (total number of glomeruli ≤10) occurred in 3 cases (4.4%), and bleeding events in 5 cases (7.3%). No clear correlation was observed between the number of punctures, hypertension, abdominal circumference, and bleeding events. Discussion: Since bleeding complications did not increase with the number of punctures, it is recommended that a sufficient number of punctures be performed to collect an adequate volume of specimens for diagnosis.