Shireen Hayatghaibi of Texas Children's Hospital in Houston and colleagues included 850 renal biopsy procedures conducted in 626 patients. Of the total biopsies, real-time ultrasound guidance was performed in 375 and preprocedure ultrasound-aided skin marking in 475. The researchers categorized any complications according to Society of Interventional Radiology (SIR) criteria:
- SIR A: No therapy, no consequence
- SIR B: Nominal therapy, no consequence
- SIR C: Requires therapy and minor hospitalization
- SIR D: Requires major therapy, unplanned increase in level of care, and prolonged hospitalization
Among the biopsies performed, 283 (33.3%) complications were detected: 60 (16%) in the real-time ultrasound guidance group and 223 (47%) in the conventional skin marking group.
In the real-time ultrasound group, 43 complications (11.5%) were categorized as SIR A and eight (2.1%) as SIR B. In the skin marking group, 156 (32.8%) biopsies resulted in SIR A complications and 54 (11.4%) in SIR B.
The researchers found no detectable difference in major complications between the groups. Real-time ultrasound-guided biopsy had six (1.6%) SIR C and three (0.8%) SIR D complications, while skin marking had 12 (2.5%) SIR C and one (0.2%) SIR D complication.
"Patients who underwent real-time ultrasound-guided renal biopsies had significantly fewer minor complications, including those that required follow-up medical care, compared to those who underwent preprocedure ultrasound-aided skin marking," Hayatghaibi's group concluded.
