The effect of primary operator specialty on diagnostic yield and bleeding complications following percutaneous native renal parenchymal biopsy.

Objectives: To evaluate the safety and efficacy of image-guided percutaneous native renal parenchymal biopsy when performed by abdominal radiologists and nephrologists.

Methods: This IRB-approved single institution retrospective study included all patients undergoing percutaneous native renal parenchymal biopsies performed by abdominal radiologists and nephrologists 1/1/22-12/31/23. Basic demographic data (age, sex, weight), guidance modality, needle gauge, biopsy technique, number of core samples, adverse events, and number of glomeruli obtained were all collected from the electronic health record. Adverse events were graded according to Common Terminology of Adverse Events criteria. Categorical variables were compared with a Fisher exact test and continuous variables were compared with a t-test. Multivariable regression analysis was performed to assess variables that were predictive of adverse events.

Results: A total of 375 biopsies were performed during the study period, 109 by radiologists and 266 by nephrologists. Diagnostic rate was 100% [109/109] for radiologists and 99.2% [264/266] for nephrologists (p=1.0). Mean number of glomeruli (36.7 vs. 30.9; p<0.001) was higher for biopsies performed by radiologists. Patients undergoing radiologist-performed biopsies were heavier (mean weight 95.8 kg vs 75.1 kg, p<0.001). The incidence of grade 3 or 4 adverse events was similar for radiologists compared to nephrologists (0.9% [1/109] vs 1.1% [3/266]; p=1.0).

Conclusion: Percutaneous renal parenchymal biopsies performed by both specialties achieved nearly universal diagnostic success and had low rates of major complications. Slightly more glomeruli were obtained with radiologist-performed biopsies.