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What are the potential complications of a kidney biopsy?
Due to the vascular nature of the kidney, the primary complications associated with a kidney biopsy are related to bleeding.
Microscopic hematuria is the most common consequence of the procedure, but is asymptomatic and resolves spontaneously.
Similarly, mild drops in hemoglobin concentration and silent perinephric hematomas (detected by routine screening imaging) are common but are not considered to be complications.
Arteriovenous fistulas can be found in up to 18% of patients; however, most are clinically asymptomatic and resolve spontaneously within 2 years.
Symptomatic fistulas can result in hematuria, hypertension, high-output cardiac failure, and kidney impairment, which can require arterial embolization or surgical ligation.
Outside of bleeding, other complications of kidney biopsy are rare.
They include Page Kidney (renin-mediated hypertension from pressure-induced ischemia from a perinephric hematoma), puncture of nearby organs (typically liver, pancreas, or spleen), pneumothorax, hemothorax, and perirenal soft tissue infection.
Here is the table which details the incidence of the various bleeding complications
Incidence of Percutaneous Kidney Biopsy (with Ultrasound Guidance) Bleeding Complications
| Complication | Approximate Incidence |
|---|---|
| Macroscopic hematuria | 3.5% |
| Perinephric hematoma | 2.5%–17% |
| Requirement of blood transfusion | 0.9%–17% |
| Requirement of angiographic intervention | 0.6% |
| Bladder obstruction from hemorrhage | 0.3% |
| Requirement of nephrectomy | 0.01% |
| Death | 0.02%–0.1% |
