B Peters1, B Stegmayr2, J Mölne3, S-B Haux4, H Hadimeri5. 1. Department of Nephrology, Skaraborg Hospital, Skövde, Sweden; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Electronic address: bjorn.peters@vgregion.se. 2. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 3. Department of Pathology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. 4. Department of Radiology, Skaraborg Hospital, Skövde, Sweden. 5. Department of Nephrology, Skaraborg Hospital, Skövde, Sweden.
Abstract
BACKGROUND: Transplant kidney biopsies are performed to determine a histological diagnosis for specific patient treatment. The aim of this study was to investigate if Resistive Index (RI) could be a predictor for biopsy complications. METHODS: In this study, 220 consecutive transplant kidney biopsies (136 men and 84 women; median age, 55.5 years) were prospectively included. RI (median, 0.7) was measured by use of ultrasound. Histological diagnoses and biopsy complications were registered. Biopsy needles were either 16- or 18-gauge. Biopsies were performed by radiologists and were carried out as an outpatient procedure (70%) or an inpatient procedure (30%). Usually three passes per biopsy were performed. RESULTS: The overall complication rate was 6.8%, divided into major (4.5%) and minor (2.3%) complications. An RI ≥0.8 predicts major (13.3% versus 3.2%; risk ratio [RR], 4.2; confidence interval [CI], 1.3-14.1; P = .03) and overall biopsy complications (16.7% versus 5.3%; RR, 3.2; CI, 1.2-8.6; P = .04) compared with RI <0.8. In the group <0.8, RI correlated with age (rs = 0.28, P < .001) and systolic blood pressure (rs = 0.18, P = .02). In the group ≥0.8, RI correlated with degree of interstitial fibrosis (rs = 0.65, P = .006) and systolic blood pressure (rs = 0.40, P = .03). The multiple regression analysis showed that in the group <0.8, the RI correlated only with age (P < .001), whereas in the group ≥0.8, RI correlated only with the degree of interstitial fibrosis (P = .003). CONCLUSIONS: An RI ≥0.8 indicates greater risk for major and overall biopsy complications and should result in greater caution after biopsy.
BACKGROUND: Transplant kidney biopsies are performed to determine a histological diagnosis for specific patient treatment. The aim of this study was to investigate if Resistive Index (RI) could be a predictor for biopsy complications. METHODS: In this study, 220 consecutive transplant kidney biopsies (136 men and 84 women; median age, 55.5 years) were prospectively included. RI (median, 0.7) was measured by use of ultrasound. Histological diagnoses and biopsy complications were registered. Biopsy needles were either 16- or 18-gauge. Biopsies were performed by radiologists and were carried out as an outpatient procedure (70%) or an inpatient procedure (30%). Usually three passes per biopsy were performed. RESULTS: The overall complication rate was 6.8%, divided into major (4.5%) and minor (2.3%) complications. An RI ≥0.8 predicts major (13.3% versus 3.2%; risk ratio [RR], 4.2; confidence interval [CI], 1.3-14.1; P = .03) and overall biopsy complications (16.7% versus 5.3%; RR, 3.2; CI, 1.2-8.6; P = .04) compared with RI <0.8. In the group <0.8, RI correlated with age (rs = 0.28, P < .001) and systolic blood pressure (rs = 0.18, P = .02). In the group ≥0.8, RI correlated with degree of interstitial fibrosis (rs = 0.65, P = .006) and systolic blood pressure (rs = 0.40, P = .03). The multiple regression analysis showed that in the group <0.8, the RI correlated only with age (P < .001), whereas in the group ≥0.8, RI correlated only with the degree of interstitial fibrosis (P = .003). CONCLUSIONS: An RI ≥0.8 indicates greater risk for major and overall biopsy complications and should result in greater caution after biopsy.