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Bleeding risk after native and transplant kidney biopsy - a single-centre observational study
Céline Fontana1, Matthias Diebold1, Patrizia Amico1
1Clinic for Transplantation Immunology and Nephrology, University Hospital, Basel, Switzerland.
Swiss Medical Weekly
|June 26, 2025
Summary
Kidney biopsies carry a risk of bleeding complications, particularly in patients with reduced estimated glomerular filtration rate (eGFR). A low eGFR, especially below 30 ml/min, significantly increases bleeding risk in both native and transplant kidney biopsies.
Area of Science:
- Nephrology
- Urology
- Internal Medicine
Background:
- Renal biopsies are crucial for diagnosing and managing kidney diseases.
- Bleeding complications, though infrequent, remain a concern following kidney biopsies.
Purpose of the Study:
- To analyze complication rates in native and transplant kidney biopsies.
- To investigate the association between platelet function analyzer bleeding time (PFA BT), estimated glomerular filtration rate (eGFR), and significant bleeding complications.
Main Methods:
- An observational study of 819 ultrasound-guided kidney biopsies (2015-2019).
- Assessment included PFA BT, INR, platelet count, and eGFR.
- Significant bleeding defined by hemoglobin decrease >10 g/l or transfusion need.
Main Results:
- Overall complication rate was 3.9% (6.3% native, 2.6% transplant).
- Low eGFR and prolonged PFA BT were associated with bleeding complications.
- Multivariable analysis identified low eGFR as the only significant independent factor (OR 3.57).
Conclusions:
- Reduced eGFR, particularly <30 ml/min, is a significant risk factor for bleeding complications in kidney biopsies.
- This finding is relevant for both native and transplant kidney biopsies.
- Pre-biopsy assessment of eGFR is critical for risk stratification.
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