Abstract: PUB205
Native Percutaneous Kidney Biopsy Findings: A 10-Year, Single-Center, Retrospective Study
Session Information
Category: Pathology and Lab Medicine
- 1700 Pathology and Lab Medicine
Authors
- El-Bizri, Raina, Brown University, Providence, Rhode Island, United States
- Patel, Pooja V., Brown University, Providence, Rhode Island, United States
- Raker, Christina A., Brown University, Providence, Rhode Island, United States
- Omara, AnnMarie, Brown University, Providence, Rhode Island, United States
- Shah, Ankur, Brown University, Providence, Rhode Island, United States
- Merhi, Basma Omar, Brown University, Providence, Rhode Island, United States
Background
Percutaneous renal biopsy (PRB) remains the gold standard for diagnosing kidney disease. We evaluated diagnostic yield and spectrum of pathology observed over a 10-year period.
Methods
We conducted a retrospective review of adult patients who underwent native PRB at Rhode Island Hospital between 2015 and 2025. Clinical and histopathologic data were analyzed to determine the distribution of renal pathology, using logistic regression with robust standard errors to account for within-patient correlation.
Results
A total of 829 native biopsies were performed on 778 patients (range:1-4). Median age was 56 years (interquartile range [IQR]:37-69), 47.6% were male (n=390), 20.7% were Hispanic (n=170), 11.5% were non-Hispanic Black (n=94), and 58.1% were non-Hispanic White (n=476). Most biopsies were performed by nephrology (n=508, 62%) compared with interventional radiology (n=312, 38%).
The most common pathologic diagnoses identified (not mutually exclusive) were chronic kidney disease-related changes (n=176, 21.5%), acute tubular injury (n=169, 20.6%), focal segmental glomerulosclerosis FSGS (n=157, 19.2%), acute interstitial nephritis (n=156, 19.0%), diabetic nephropathy (n=140, 17.1%), IgA nephropathy (n=112, 13.5%), lupus nephropathy (n=91, 11.1%), membranous nephropathy (n=90, 11.0%), ANCA-associated glomerulonephritis (AAGN) (n=78, 9.5%), and thrombotic microangiopathy (n=77, 9.4%).
Among biopsies with diabetic nephropathy (n=140), 82.1% (n=115) demonstrated concurrent non-diabetic renal pathology. Older age was associated with higher prevalence of acute tubular injury and AAGN, whereas obesity was associated with increased FSGS and diabetic nephropathy (Table 1). Seven biopsies had normal pathology. The median number of glomeruli per biopsy was 15 (IQR:9-23).
Conclusion
Native kidney biopsy provides high diagnostic yield and frequently identifies overlapping renal pathologies, particularly in diabetic nephropathy, underscoring its continued role in refining diagnosis and guiding management.