A 5-year experience with 307 CT-guided renal biopsies: results and complications.

Three hundred four patients with diffuse renal disease underwent 307 consecutive percutaneous biopsies with use of nonenhanced computed tomographic (CT) guidance and the 14-gauge Vim Silverman needle. Satisfactory tissue for histopathologic diagnosis was obtained in 100% of cases. Precise data collection before and after the last 241 biopsies enabled diagnosis of 18 hemorrhagic complications (7.5%). The conditions of five patients stabilized without intervention. Thirteen patients received blood transfusions, and one required therapeutic embolization. One death occurred in a patient with advanced systemic lupus erythematosus. Two nonhemorrhagic complications were fevers after biopsy, both of which resolved without sequelae. Review of medical records revealed increased hemorrhagic complication rates in dialysis patients, female patients, patients who underwent left-sided biopsies, and patients pretreated with 1-deamino-8-D-arginine vasopressin to reverse uremic platelet dysfunction. No complications were associated with biopsies in 14 pediatric patients (younger than 16 years) and 10 renal transplant recipients. Risk of hemorrhagic complications had no correlation with patient age (when older than age 16 years) and 10 renal transplant recipients. Risk of hemorrhagic complications had no correlation with patient age (when older than age 16 years), creatinine level, hematocrit, pathologic features of resultant biopsy specimen, or whether the patient was admitted solely for the biopsy.