Abstract: FR-PO946

Should Kidney Biopsies Be Done via CT-Guidance? Comparison of Percutaneous Native Kidney Biopsy Complications and Glomerular Yield between Interventional Radiologists and Nephrologists

Session Information

  • Patient Safety
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Patient Safety

  • 1501 Patient Safety

Authors

  • Amante, Brigani G., UNIVERSITY OF COLORADO, HOUSTON, Texas, United States
  • Jani, Alkesh, University of Denver Colorado, Aurora, Colorado, United States
Background

Percutaneous native kidney biopsy (PNKB) is performed as an out-patient procedure by interventional radiologists (IR) & nephrologists. However, data on tissue yield & complication rates comparing IR performed (IRP) & nephrology performed (NP) PNKB are lacking. Also, there is no published study that directly compares outcomes of PNKBs performed via computed tomography (CT) vs. ultrasound (US) guidance.

Methods

131 PNKBs performed at the University of Colorado Health System from 1/2014-12/2016 were included. Biopsies were performed by nephrologists using real-time US guidance or IR using CT guidance.

Results

72 biopsies were done by nephrologists & 59 by IR. The NP group had a significantly longer duration of patient observation post-biopsy (20.7 vs 5.0 hrs, p < 0.05), used a larger biopsy needle (16G in 93% vs 18G in 100% of patients, p < 0.05), had lower number of needle passes (2.8 vs 3.5, p < 0.05), & had higher glomerular yield/needle pass (8.9 vs 6.4, p = 0.05) with lower rate of inadequate tissue (6.9% vs 18.6%, p = 0.05) than the IRP group. No differences in post-biopsy complications such as hematoma, hematuria, need for transfusion or intervention, analgesic use, emergency room visits, infection/sepsis, or patient death were observed between the groups.

Conclusion

Out-patient PNKB done via CT guidance had similar complication rates vs. real-time US guidance, and required a significantly shorter period of patient observation post-biopsy. Tissue yield was significantly better with real-time US guidance than with CT guidance, likely due to use of a larger-gauge needle. CT guided biopsy by IR offers similar complication rates for significantly less observation time vs US by Nephrology.