Percutaneous Kidney Biopsy and the Utilization of Blood Transfusion and Renal Angiography Among Hospitalized Adults

Introductions: Kidney biopsy is the standard tool to diagnose glomerular disease (GD). There is lack of national registry of kidney biopsy for the type, incidence and prevalence of GD. We aim to review kidney biopsy at Patan Hospital for profile of GD in local scenario. Methods: This was a chart review of patients who underwent kidney biopsy at Patan Hospital, Nepal, from October 2013 to September 2015. We analyzed the data for indication of kidney biopsy, types of GD and complication of biopsy. Results: There were 117 patients who had kidney biopsies. Immunoglobulin A Nephropathy was seen in 42 (35.8%) and Lupus Nephritis in 38 (32.5%). Sub nephrotic range proteinuria with or without active urinary sediments was found in 75 (64%). Blood transfusion was required in 3 (2.5%) patients after biopsy. There was no surgical intervention or mortality related to biopsy. Conclusions: IgA Nephropathy was the commonest glomerular disease. Kidney biopsy was a safe and effective procedure.

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Performance of CT-Guided Percutaneous Kidney Biopsy by Nephrologists With 100% Tissue Diagnosis and No Blood Transfusion Over 10-Year Period

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2012.02.312 ◽

2012 ◽

Vol 59 (4) ◽

pp. B91

Keyword(s):

Blood Transfusion ◽

Kidney Biopsy ◽

Ct Guided ◽

Tissue Diagnosis

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Bleeding Complications after Pediatric Kidney Biopsy

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.05890518 ◽

2018 ◽

Vol 14 (1) ◽

pp. 57-65 ◽

Cited By ~ 7

Author(s):

Charles D. Varnell ◽

Hillarey K. Stone ◽

Jeffrey A. Welge

Keyword(s):

Blood Transfusion ◽

Confidence Interval ◽

Pediatric Patients ◽

Kidney Biopsy ◽

Meta Analysis ◽

Secondary Analysis ◽

Outpatient Setting ◽

Bleeding Complications ◽

Additional Intervention ◽

Transplant Kidney

Background and objectivesKidney biopsy is an essential tool for the diagnosis and treatment of patients with kidney disease; however, because of its invasive nature, bleeding complications may arise.Design, setting, participants, & measurementsWe performed a meta-analysis of prospective or retrospective observational studies and randomized, controlled trials in pediatric patients undergoing native or transplant kidney biopsy in an inpatient or outpatient setting in MEDLINE-indexed studies from January 1998 to November 1, 2017 to determine the proportion of patients who develop hematoma, need blood transfusion, or need an additional intervention due to a complication after kidney biopsy.ResultsTwenty-three studies of 5504 biopsies met inclusion criteria. The proportion of patients developing hematoma after biopsy was between 11% (95% confidence interval, 7% to 17%) and 18% (95% confidence interval, 9% to 35%) using two analyses that included different time periods. The proportion needing blood transfusion was 0.9% (95% confidence interval, 0.5% to 1.4%). The proportion needing an additional intervention due to postbiopsy complication was 0.7% (95% confidence interval, 0.4% to 1.1%). Secondary analysis was not possible due to lack of data in the original manuscripts on laboratory values, needle gauges, number of needle passes, age of patient, or performer (attending versus trainee). Analysis with metaregression found that use of real-time ultrasound during biopsy did not modify the risk for hematoma, requirement of a blood products transfusion, or requirement of an additional procedure after biopsy. Analysis with metaregression comparing native biopsies with transplant biopsies did not reveal that biopsy type (native kidney biopsy versus transplant kidney biopsy) was associated with the need for a blood transfusion or requirement of an additional intervention after biopsy.ConclusionsThe development of perinephric hematoma after kidney biopsy is not an infrequent finding. The proportion of patients requiring blood transfusion or needing an additional intervention as a result of kidney biopsy in pediatric patients is significantly smaller.

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