Audit of ultrasound-guided percutaneous renal biopsies
Lois Scoffield, Leeds Teaching Hospitals NHS Trust Aims
Aims
This audit was undertaken to assess the sample diagnostic adequacy and safety/complication rates of ultrasound-guided percutaneous renal biopsies performed in a teaching hospital.
Methods
Data were collected retrospectively from a six-month period (September 2020–February 2021) from the trust’s electronic patient records and RIS. The sample adequacy for native renal kidneys was set at the presence of 10 or more glomeruli in the core biopsy, which was based on a previous audit cycle and Royal College of Radiologists audit template. The Banff Criteria – presence of 10 or more glomeruli and two or more arteries in the core biopsy - formed the standards for the transplant biopsies. Any subsequent complications or repeat biopsies were recorded.
Results
Data from 179 patients were included. 30 biopsies were targeted (at a focal lesion), 92 were native (non-targeted) and 57 were transplant biopsies. Operators included Radiology Registrars, Consultant Radiologists and Sonographers. 89% of the targeted biopsies were diagnostic. 66% of the native biopsies were adequate (57% in the previous audit), with a 4% repeat biopsy rate (3% previously). 72% of the transplant biopsies were adequate (67% previously), with a 4% repeat biopsy rate (3% previously). There was a 4% minor complication rate (not previously assessed). One patient (0.6%) had a major complication of active renal bleeding requiring interventional radiological embolisation.
Conclusion
This audit cycle demonstrated that ultrasound-guided percutaneous renal biopsies is a safe and effective procedure with a very low major complication rate and a high chance of obtaining a diagnostic sample for histopathological analysis.