Structured safety pathway makes kidney biopsies safer for vulnerable patients
A prospective study applied the ROCKY standardized protocol to 1,096 kidney biopsies in patients with high-risk features. Severe complications occurred in 0.8% of procedures, with no kidney removals or procedure-related deaths. Traditional risk factors such as older age, impaired kidney function, and blood-thinning therapy were not independently linked to severe complications.
A prospective study tracked 1,096 biopsies in people preselected as higher risk. The ROCKY pathway used fixed checkpoints before, during, and after sampling to limit bleeding and other harms while preserving diagnostic yield. Serious adverse events occurred in 0.8%; no nephrectomies or deaths tied to the procedure were reported.
Inpatient and outpatient outcomes did not differ significantly. Older age, reduced kidney function, and antiplatelet or anticoagulant use were not independently associated with serious events. Diagnostic accuracy was achieved in every procedure. The results were presented at ASN Kidney Week 2026 by a University of Turin team.
If these findings hold, standardized biopsy pathways may reassure clinicians and patients who have been considered too risky, potentially widening access to needed kidney diagnoses. People with advanced kidney disease, older adults, those on blood thinners, or with obesity/anatomical issues could benefit. More outpatient procedures could reduce hospital stays and use resources differently, though implementation and local expertise may shape real-world effects.