TORNA ALL’ELENCO

Safety profile of outpatient percutaneous native renal biopsy: A large monocentric single operator cohort in Journal of the American Society of Nephrology

2017
ASL Città di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (3)

Roccatello D

Sciascia S

Fenoglio R

Abstract

Background: In the study we aim to evaluate the safety of performing percutaneous renal biopsy as an outpatient procedure compared to the traditional inpatient policy. Additionally, the rate and risk factors of complications after a procedure were investigated. Methods: We ambispectively studied native kidney biopsies performed in our Institution between January 2000 and November 2015. Since January 2012, we began performing renal biopsies as outpatient procedures. Two groups of patients were considered: group I, in whom kidney biopsy was performed and followed by at least 1-day hospital admission; and group II, in whom renal biopsy was performed in the outpatient department and followed by 6 hours' observation period and then by regular outpatient visits. All biopsies were performed by a single nephrologist with the use of real-time ultrasound and automated biopsy needle (18 gauge), following a structured protocol. Results: 462 biopsies were reviewed, 210 (45.5%) of patients were female and the mean age was 54.7 plusmn;17.9 years. One-hundred and twenty-nine (27.9%) of these biopsies were performed in outpatients. A total of 36 (7.8%) of patients developed a complication, and of those 9 (1.9%) suffered for a major complication [arteriovenous fistula (6 cases, 1.2%), ischaemic stroke (2, 0.4%), thromboembolic pulmonary embolism (1, 0,2%)] and 27 (5.8%) for minor [macroscopic haematuria (12 cases, 2,6%), haematomas on sonography not requiring intervention (15 cases, 3,2%)]. When comparing the complication rate between group I and II, no statically difference were observed [overall 24 (7,2%) complications in group 1 and 12 (9,3%) in group II; 5 (1,5%) and 4 (3,1%) major, 19 (5,5%) and 8 (6.2%) minor complications, respectively in group I and II]. When analysing together both groups, after multivariate analysis, serum creatinine >3 mg/dl (OR 2.03 95%CI 1.18-6.81) and known severe hypertension (OR 2.01 95%CI 1.2-4.7) were found to be independent risk factors for

Keywords

arteriovenous fistula; adult; creatinine; risk factor; real time echography; proteinuria; outpatient department; nephrologist; middle aged; male; lung embolism; kidney tissue; kidney biopsy; hypertension; human tissue; human; hospital patient; hematuria; hematoma; gender; gauge; female; creatinine blood level; conference abstract; complication; case report; clinical article; brain ischemia;