Background: In the US, native kidney biopsies are usually inpatient procedures. We developed an outpatient biopsy protocol for low-risk patients and assessed its safety and efficacy. Methods: Patients with an SBP <140 mm Hg and a BMI ≤35 who were not taking anticoagulants, ASA and NSAIDS in the preceding week were included. Biopsies were performed under ultrasound guidance using a 15-gauge needle that changed to a 14-gauge needle during the study. Patients were discharged after 5 h of observation if there were no signs of bleeding. Complications were carefully recorded. Results: Between November 2008 and April 2011, 105 patients underwent outpatient renal biopsies. A 15-gauge needle was used in 43 patients (group A) while a 14-gauge needle was used in 62 (group B). A median of 25 (range 4–64) glomeruli were obtained in group A versus 39 (range 0–107) in group B (p < 0.001). Complications requiring admission for observation occurred in 7 patients (16%) in group A versus 5 patients (8%) in group B (p = 0.22). One patient in group B had bleeding requiring intervention, while all other complications were minor. Nine complications occurred during the observation period, while 3 patients presented >48 h after biopsy. The mean cost per patient for each outpatient biopsy was USD 976 versus USD 5,489 for inpatients. Conclusions: In a selected low-risk population, outpatient renal biopsy is safe with low complication rates and results in significant cost savings relative to elective inpatient biopsies. The use of a 14-gauge biopsy needle resulted in a greater yield of glomeruli without increased complications.

Buonocore E, Skipper GJ: Steerable real-time sonographically guided needle biopsy. AJR Am J Roentgenol 1981;136:387–392.
Donovan KL, Thomas DM, Wheeler DC, Macdougall IC, Williams JD: Experience with a new method for percutaneous renal biopsy. Nephrol Dial Transplant 1991;6:731–733.
Burstein DM, Korbet SM, Schwartz MM: The use of the automatic core biopsy system in percutaneous renal biopsies: a comparative study. Am J Kidney Dis 1993;22:545–552.
Whittier WL, Korbet SM: Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol 2004;15:142–147.
Whittier WL, Korbet SM: Renal biopsy: update. Curr Opin Nephrol Hypertens 2004;13:661–665.
Waldo B, Korbet SM, Freimanis MG, Lewis EJ: The value of post-biopsy ultrasound in predicting complications after percutaneous renal biopsy of native kidneys. Nephrol Dial Transplant 2009;24:2433–2439.
Stratta P, Canavese C, Marengo M, Mesiano P, Besso L, Quaglia M, et al: Risk management of renal biopsy: 1387 cases over 30 years in a single centre. Eur J Clin Invest 2007;37:954–963.
Marwah DS, Korbet SM: Timing of complications in percutaneous renal biopsy: what is the optimal period of observation? Am J Kidney Dis 1996;28:47–52.
Al-Hweish AK, Abdul-Rehaman IS: Outpatient percutaneous renal biopsy in adult patients. Saudi J Kidney Dis Transpl 2007;18:541–546.
Maya ID, Allon M: Percutaneous renal biopsy: outpatient observation without hospitalization is safe. Semin Dial 2009;22:458–461.
Margaryan A, Perazella MA, Mahnensmith RL, Abu-Alfa AK: Experience with outpatient computed tomographic-guided renal biopsy. Clin Nephrol 2010;74:440–445.
Carrington CP, Williams A, Griffiths DF, Riley SG, Donovan KL: Adult day-case renal biopsy: a single-centre experience. Nephrol Dial Transplant 2011;26:1559–1563.
Khajehdehi P, Junaid SM, Salinas-Madrigal L, Schmitz PG, Bastani B: Percutaneous renal biopsy in the 1990s: safety, value, and implications for early hospital discharge. Am J Kidney Dis 1999;34:92–97.
Nicholson ML, Wheatley TJ, Doughman TM, White SA, Morgan JD, Veitch PS, et al: A prospective randomized trial of three different sizes of core-cutting needle for renal transplant biopsy. Kidney Int 2000;58:390–395.
Arora K, Punia RS, D’Cruz S: Comparison of diagnostic quality of kidney biopsy obtained using 16G and 18G needles in patients with diffuse renal disease. Saudi J Kidney Dis Transpl 2012;23:88–92.
Racusen LC, Colvin RB, Solez K, Mihatsch MJ, et al: Antibody-mediated rejection criteria – an addition to the Banff 97 classification of renal allograft rejection. Am J Transplant 2003;3:708–714.
Hussain F, Mallik M, Marks SD, Watson AR: British Association of Paediatric Nephrology. Renal biopsies in children: current practice and audit of outcomes. Nephrol Dial Transplant 2010;25:485–489.
Manno C, Strippoli GF, Arnesano L, Bonifati C, Campobasso N, Gesualdo L, et al: Predictors of bleeding complications in percutaneous ultrasound-guided renal biopsy. Kidney Int 2004;66:1570–1577.
Maya ID, Maddela P, Barker J, Allon M: Percutaneous renal biopsy: comparison of blind and real-time ultrasound-guided technique. Semin Dial 2007;20:355–358.
Shidham GB, Siddiqi N, Beres JA, Logan B, Nagaraja HN, Shidham SG, et al: Clinical risk factors associated with bleeding after native kidney biopsy. Nephrology (Carlton) 2005;10:305–310.
Kolb LG, Velosa JA, Bergstralh EJ, Offord KP: Percutaneous renal allograft biopsy. A comparison of two needle types and analysis of risk factors. Transplantation 1994;57:1742–1746.
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