Randah Abdullah Dahlan1*, Guzaiz Noha H2 and Almarwni Abdulhakim A1
Background and objectives: Renal biopsy is an essential diagnostic tool used by nephrologists to establish the diagnosis of many glomerular diseases. The absence of an adequate biopsy sample may affect the course of management of patients who may suffer from a serious underlying disease requiring an early initiation of therapy. We conducted a quality improvement project aiming to assess the rate of adequate percutaneous native kidney biopsy samples in the absence of on-site microscopic examination of samples. Furthermore, the project also aimed to study the effect of some variables on the adequacy rate.
Methods: We included all percutaneous native kidney biopsies performed between January 1, 2017, and December 31, 2020. We excluded allograft renal biopsies from this study. Data were retrospectively collected; and included: patient-related data, procedure-related data, and biopsy results-related data. The sample was labeled as adequate if at least ten glomeruli were seen on light microscopy, and at least one glomerulus on immunofluorescence and one glomerulus on electron microscopy. Biopsies not fulfilling the aforementioned criteria were labeled as inadequate.
Results: Out of 82 percutaneous native kidney biopsies, 35 biopsies (43%) were adequate and the remaining 47 biopsies (57%) were inadequate. When comparing the adequate versus the inadequate group we found that the age, gender, weight, BMI, operator, needle size, number of passes, and the number of cores were the same in both groups.
Conclusion: Our study demonstrates the high rate of inadequate renal biopsy samples associated with the lack of on-site microscopic examination of samples. Age, gender, weight, BMI, operator, needle size, number of passes, and number of cores did not affect the rate of the adequacy. The small sample size represents a limitation of this study.
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