Systematic Review and Meta-Analysis of Native Kidney Biopsy Complications
Year: 2020
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: BACKGROUND AND OBJECTIVES: Native kidney biopsies are commonly performed in the diagnosis of acute kidney diseases and CKD. Because of the invasive nature of the procedure, bleeding-related complications are not uncommon. The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases-sponsored Kidney Precision Medicine Project requires that all participants undergo a kidney biopsy; therefore, the objective of this analysis was to study complication rates of native kidney biopsies performed using automated devices under kidney imaging. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a systematic review and meta-analysis of the literature published from January 1983 to March 2018. The initial PubMed search yielded 1139 manuscripts. Using predetermined selection criteria, 87 manuscripts were included in the final analysis. A random effects meta-analysis for proportions was used to obtain combined estimates of complication rates. Freeman-Tukey double-arcsine transformations were used to stabilize variance as complications were rare. RESULTS: A total of 118,064 biopsies were included in this study. Patient age ranged from 30 to 79 years, and 45% of patients were women. On the basis of our meta-analysis, pain at the site of biopsy is estimated to occur in 4.3% of biopsied patients, hematomas are estimated to occur in 11%, macroscopic hematuria is estimated to occur in 3.5%, bleeding requiring blood transfusions is estimated to occur in 1.6%, and interventions to stop bleeding are estimated to occur in only 0.3%. Death attributed to native kidney biopsy was a rare event, occurring only in an estimated 0.06% of all biopsies but only 0.03% of outpatient biopsies. Complication rates were higher in hospitalized patients and in those with acute kidney disease. The reported complications varied on the basis of study type and geographic location. CONCLUSIONS: Although the native kidney biopsy is an invasive diagnostic procedure, the rates of bleeding complications are low. Albeit rare, death can occur postbiopsy. Complications are more frequently seen after kidney biopsies of hospitalized patients with AKI.
DOI: 10.2215/cjn.04710420
Authors: Emilio D. Poggio, Robyn L. McClelland, Kristina N. Blank, Spencer Hansen, Shweta Bansal, Andrew S. Bomback, Pietro A. Canetta, Pascale Khairallah, Krzysztof Kiryluk, Stewart H. Lecker, Gearoid M. McMahon, Paul M. Palevsky, Samir Parikh, Sylvia E. Rosas, Katherine Tuttle, Miguel A. Vazquez, Anitha Vijayan, Brad H. Rovin, for the Kidney Precision Medicine Project
Institutions: Broad Institute, Boston University, Brigham and Women's Hospital, Joslin Diabetes Center, Beth Israel Deaconess Medical Center, Cleveland Clinic, Pacific Northwest National Laboratory, Johns Hopkins University, The University of Texas at San Antonio Health Science Center, University of Pittsburgh, Duke University, University of California, San Francisco, Princeton University, University of Washington, Washington University in St. Louis, University of Michigan, Yale University, University of California San Diego, Parkland Center For Clinical Innovation, American Association of Kidney Patients, European Molecular Biology Laboratory, Indiana University Indianapolis, Glickman Urological Institute, The Ohio State University, Case Western Reserve University, Columbia University, The University of Texas Southwestern Medical Center, VA Pittsburgh Healthcare System, The Ohio State University Wexner Medical Center, Harvard University, Providence Sacred Heart Medical Center
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Harvard Chronic Kidney Disease Research Biopsy Center, Central Hub for Kidney Precision Medicine, PREcision Medicine through IntErrogation of Rna in the kidnEy (PREMIERE), Chronic Kidney Disease Precision Medicine Project, Phenotyping REnal Cases In Sepsis and surgery for Early Acute Kidney Injury (PReCISE AKI), Nephron Sub-segmental Omics and Quantitative 3D Imaging of Human Kidney., AKI Matched Phenotype Linked Evaluation with Tissue (AMPLE-Tissue), Chronic Kidney Disease Precision Medicine Project, Multidimensional cellular interrogation of the kidney in AKI and CKD, Phenotyping REnal Cases In Sepsis and surgery for Early Acute Kidney Injury (PReCISE AKI), Cleveland Precision Medicine Chronic Kidney Disease Cohort, Kidney Precision Medicine Program (KPMP): Columbia AKI Recruitment Site, Spatial Metabolomics for Human Kidneys, Single-nucleus sequencing and in situ mapping of mRNA molecules in human kidney, Central Hub for Kidney Precision Medicine
OpenAlex ID: W3093379187