Kidney Week

Abstract: TH-PO1065

Effect of BMI and Weight on Safety of CT-Guided Native Kidney Biopsy: A Single-Center Study

Session Information

• Pathology and Lab Medicine
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

• 1700 Pathology and Lab Medicine

Authors

• Wong, Karen, The University of Mississippi Medical Center, Jackson, Mississippi, United States

Karen Wong

• Velagapudi, Ramya Krishna, The University of Mississippi Medical Center, Jackson, Mississippi, United States

Ramya Krishna Velagapudi, MD, FASN

• Tio, Maria Clarissa, The University of Mississippi Medical Center, Jackson, Mississippi, United States

Maria Clarissa Tio, MD, MPH, FASN

• Yen, Timothy E., The University of Mississippi Medical Center, Jackson, Mississippi, United States

Timothy E. Yen, MD, MS

• Dossabhoy, Neville R., The University of Mississippi Medical Center, Jackson, Mississippi, United States

Neville R. Dossabhoy, MD, FASN

• Obi, Yoshitsugu, The University of Mississippi Medical Center, Jackson, Mississippi, United States

Yoshitsugu Obi, MD, PhD, FASN

Background

Native kidney biopsies are traditionally performed under ultrasound (US) guidance, whereas the CT-guided approach is preferred in patients with larger body habitus. At our institution, the CT-guided approach has become a routine practice for all kidney biopsies. We evaluated kidney biopsy complication rates across body mass index (BMI) and absolute weight categories and compared them to those reported in the literature.

Methods

A total of 144 native kidney biopsies were performed at an academic medical center from November 2023 to April 2025. All biopsies were performed under CT guidance. Patients’ BMI and weight were collected prior to biopsy. BMI was categorized as: normal/underweight <25 kg/m², overweight between 25 and 30 kg/m², and obese >30 kg/m². Complications were documented via chart review, including transfusion within 3 days, invasive intervention (embolization or surgery) within 4 weeks, and biopsy-related hospitalization within 3 months of biopsy.

Results

There were 80 female and 64 male patients, with a mean age of 45.9 years, ranging from 18 to 82 years. Inpatient biopsies were performed for 79 patients (54.9%); the rest were performed outpatient. Median BMI was 29.5 kg/m². Post-biopsy, 40 complications occurred, including 15 transfusions (10.4%), 4 invasive procedures (2.8%), 20 hospitalizations (13.9%), and 1 death (0.6%). The proportions of patients requiring transfusions and invasive procedures were higher than those reported in the literature (Table 1). The complication rates appeared to be inversely related to BMI; in normal/underweight, overweight, and obese patients, complication-related hospitalization rates were 20.6%, 11.9%, and 11.8%, transfusion rates were 14.7%, 11.9%, and 7.4%, and invasive intervention rates were 5.9%, 2.4%, and 1.5%, respectively (Table 1). The weight-based categorization did not show clear trends in the complication rates.

Conclusion

Our study revealed that the complication rates of CT-guided native kidney biopsies were higher than those reported in literature for the US-guided method. Additionally, complication rates were even higher among non-obese patients. Further studies are warranted to validate these findings and develop risk-stratifying strategies to determine which patients benefit better from CT-guided vs US-guided kidney biopsy.