Safety of outpatient kidney biopsies

Šimunov, Bojana and Gunjača, Mihaela and Čingel, Branislav and Škegro, Dinko and Knotek, Mladen (2018) Safety of outpatient kidney biopsies. Nephron, 138 (4). pp. 275-279. ISSN 1660-8151

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BACKGROUND: Kidney biopsy is frequently performed in our centre as an outpatient procedure. The aim of this study was to evaluate the safety of biopsy in the outpatient setting. ----- METHODS: We analysed kidney biopsies performed from March 2013 to February 2017. Seven hundred twenty-five biopsies performed in the outpatient setting were identified: There were 592 transplant and 133 native biopsies including 3 solitary kidney biopsies. All were performed under ultrasound guidance using a 16G or 18G needle, with freehand technique. In all patients with estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 desmopressin was administered. Patients were observed for 6h before discharge, with a complete blood count and urine test after 4 h. Major complications were haemorrhage requiring therapeutic intervention or transfusion. Minor complications were significant reduction in haemoglobin (Hb) levels (>10%), without need for transfusion or intervention and macrohaematuria. ----- RESULTS: There were 506 (69.8%) male patients. Average age was 50.3 ± 12.7 years. Indications for native kidney biopsy included nephrotic syndrome (39.8%), nephritic syndrome (42.9%), follow-up biopsy (15.8%), and other (1.5%). There were no major complications. A decline in Hb was observed in 72% of patients. Average Hb decline was 4.2 ± 6.3 g/L. In 10.1% patients there was >10% reduction in Hb level, with no evident bleeding, including by ultrasonography. In 2.5% of patients, macrohaematuria was present. In a multivariate analysis, male gender, lower eGFR, higher pre-biopsy Hb and native kidney biopsy were predictive for Hb decline. No therapeutic interventions were required. ----- CONCLUSION: We found that kidney biopsy performed in an outpatient setting in select patients is only rarely associated with adverse events and is a safe procedure.

Item Type: Article
MeSH: Adult ; Aged ; Biopsy/adverse effects ; Biopsy/statistics & numerical data ; Female ; Glomerular Filtration Rate ; Hematuria/etiology ; Hemoglobins/analysis ; Hemoglobins/metabolism ; Hemorrhage/etiology ; Humans ; Image-Guided Biopsy ; Kidney/pathology ; Kidney Diseases/diagnosis ; Kidney Diseases/pathology ; Kidney Transplantation ; Male ; Middle Aged ; Outpatients ; Patient Safety , Retrospective Studies ; Ultrasonography, Interventional
Departments: Katedra za internu medicinu
Depositing User: Kristina Berketa
Status: Published
Šimunov, BojanaUNSPECIFIED
Gunjača, MihaelaUNSPECIFIED
Čingel, BranislavUNSPECIFIED
Date: 2018
Date Deposited: 27 Sep 2019 08:11
Last Modified: 27 Aug 2020 08:46
Subjects: /
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