scholarly journals Safety of Kidney Biopsy when Performed as an Outpatient Procedure

2021 ◽  
pp. 1-13
Author(s):  
Marco Bonani ◽  
Harald Seeger ◽  
Nina Weber ◽  
Johan M. Lorenzen ◽  
Rudolf P. Wüthrich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Major Bleeding ◽  
Kidney Biopsy ◽  
University Hospital ◽  
Renal Diseases ◽  
Safe Procedure ◽  
Surveillance Period ◽  
Outpatient Procedure ◽  
Outpatient Procedures ◽  
Transplant Kidney

<b><i>Introduction:</i></b> Kidney biopsy remains the gold standard for the diagnosis of most renal diseases. A major obstacle to performing a biopsy is safety concerns. However, many safety measures are not evidence based and therefore vary widely between centers. We sought to determine the rate and timing of kidney biopsy complications in our center, to compare the complication rate between native and transplant kidney biopsies, to evaluate the feasibility of performing kidney biopsies as an outpatient procedure and the value of a postbiopsy ultrasound before discharge, and to identify risk factors for complications. <b><i>Methods:</i></b> We performed a single-center, retrospective, observational study at the Division of Nephrology of the University Hospital Zurich including all patients who underwent renal biopsy between January 2005 and December 2017. Major bleeding (primary outcome) and any other bleeding or nonbleeding complications (secondary outcomes) were compared between native and transplant kidney biopsies and between inpatient and outpatient procedures and correlated with clinical factors possibly affecting bleeding risk. <b><i>Results:</i></b> Overall, 2,239 biopsies were performed in 1,468 patients, 732 as inpatient and 1,507 as outpatient procedures. Major bleeding was observed in 28 (3.8%) inpatient and in 15 (1.0%) outpatient procedures, totaling to 43 (1.9%) of all biopsies. Major bleeding requiring intervention amounted to 1.0% (0.5% of outpatient procedures). Rate of major bleeding was similar between native and transplant kidneys. 13/15 (87%) bleeding episodes in planned outpatient procedures were detected during the 4-h surveillance period. Risk factors for bleeding were aspirin use, low eGFR, anemia, cirrhosis, and amyloidosis. Routine postbiopsy ultrasound did not change management. <b><i>Conclusions:</i></b> Kidney biopsy is an overall safe procedure and can be performed as an outpatient procedure in most patients with an observation period as short as 4 h. The value of routine postbiopsy ultrasound is questionable.

scholarly journals Complications of Kidney Biopsy in a Tertiary Hospital of Central Nepal, Chitwan

2020 ◽  
Vol 16 (2) ◽  
pp. 62-65
Author(s):  
Madhav Ghimire ◽  
Shreeju Vaidya ◽  
Hari Prasad Upadhyay
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Standard Deviation ◽  
Kidney Biopsy ◽  
P Value ◽  
Safe Procedure ◽  
Biopsy Site ◽  
Low Platelet Count ◽  
Perinephric Hematoma ◽  
Site Pain

Background: Kidney biopsy is an important diagnostic tool in Nephrology and is said to berelatively a safe procedure.There are limited studies in the complications of kidney biopsy from this region. We therefore thought of looking into the complications of kidney biopsy and its risk factors. Methods: A hospital based analytical cross sectional study was carried out over a period of 3 years. Kidney biopsies were done under ultrasonography guidance. The complications and its risk factors were recorded and were analyzed using mean, standard deviation, ratio, percentage and chi square.   Results: A total of 210 patients were analysed. The mean± standard deviation of 210 patients was 35.7±14.9 years. The commonest minor complication was biopsy site pain not requiring analgesics 136 (64.8%)and the commonest major complication was biopsy site pain requiring analgesics 18(8.6%) followed by perinephric hematoma 10 (4.8%).There was a significant association between low platelet count and the development of complications like pain requiring analgesic (p value 0.04), perinephric   hematoma (p value 0.022) and gross hematuria (p value 0.011). Conclusions: Kidney biopsy is a safe procedure and low platelet count is a significant risk factor for complications (p value <0.05).  Keywords: complications; kidney biopsy; perinephric hematoma; platelet count.  

scholarly journals Performing an Ultrasound-Guided Percutaneous Needle Kidney Biopsy: An Up-To-Date Procedural Review

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2186
Author(s):  
Antonio Granata ◽  
Giulio Distefano ◽  
Francesco Pesce ◽  
Yuri Battaglia ◽  
Paola Suavo Bulzis ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Kidney Biopsy ◽  
Left Kidney ◽  
Renal Involvement ◽  
Observation Time ◽  
Current Evidence ◽  
Bleeding Complications ◽  
Renal Diseases ◽  
Safe Procedure ◽  
Ultrasound Guided

Ultrasound-guided percutaneous renal biopsy (PRB) has revolutionized the clinical practice of nephrology in the last decades. PRB remains an essential tool for the diagnosis, prognosis, and therapeutic management of several renal diseases and for the assessment of renal involvement in systemic diseases. In this study, we examine the different applications and provide a review of the current evidence on the periprocedural management of patients. PRB is recommended in patients with significant proteinuria, hematuria, acute kidney injury, unexpected worsening of renal function, and allograft dysfunction after excluding pre- and post-renal causes. A preliminary ultrasound examination is needed to assess the presence of anatomic anomalies of the kidney and to identify vessels that might be damaged by the needle during the procedure. Kidney biopsy is usually performed in the prone position on the lower pole of the left kidney, whereas in patients with obesity, the supine antero-lateral position is preferred. After preparing a sterile field and the injection of local anesthetics, an automatic spring-loaded biopsy gun is used under ultrasound guidance to obtain samples of renal parenchyma for histopathology. After the procedure, an ultrasound scan must be performed for the prompt identification of potential early bleeding complications. As 33% of complications occur after 8 h and 91% occur within 24 h, the ideal post-procedural observation time is 24 h. PRB is a safe procedure and should be considered a routine part of the clinical practice of nephrology.

RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

2014 ◽  
pp. 126-132
Author(s):  
Huu Tri Nguyen ◽  
Van Lieu Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Previous History ◽  
University Hospital ◽  
Safe Procedure ◽  
Perforated Duodenal Ulcer ◽  
Analgesic Requirement ◽  
Duodenal Ulcers ◽  
The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

Risk Factors and Outcome of Pretrem Labor in Pregnant Women Attending Zagazig Maternity University Hospital

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Hassan Hassan Nassar ◽  
Ali Ali ◽  
Sherin Shazly ◽  
Ahmed Mansour
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
University Hospital

Prevalence of and Risk Factors for Low Free Testosterone Levels in Japanese Men with Well-controlled Human Immunodeficiency Virus Infection

2020 ◽  
Vol 18 (5) ◽  
pp. 381-386
Author(s):  
Yusuke Yoshino ◽  
Ichiro Koga ◽  
Yoshitaka Wakabayashi ◽  
Takatoshi Kitazawa ◽  
Yasuo Ota
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Standard Deviation ◽  
Hiv Infection ◽  
Free Testosterone ◽  
Serum Levels ◽  
University Hospital ◽  
Rapid Decline ◽  
Total Testosterone ◽  
Immunodeficiency Virus

Background: The change in the prevalence of hypogonadism with age in men with human immunodeficiency virus (HIV) infection is subject to debate. Objective: To address this issue, we diagnosed hypogonadism based on serum levels of free testosterone (fTST) rather than total testosterone which is thought to be an inaccurate indicator. We also determined the relationship between age and fTST levels and identified risk factors for hypogonadism in men with HIV infection. Method: We retrospectively reviewed fTST levels and associated clinical factors in 71 wellcontrolled HIV-infected men who were treated at Teikyo University Hospital between April 2015 and March 2016 and who had data available on serum fTST levels, measured >6 months after starting antiretroviral therapy. fTST was measured using radioimmunoassay on blood samples collected in the morning. Risk factors for hypogonadism were identified using Welch’s t-test and multiple regression analysis. Results: The men had a mean (± standard deviation) age of 47.4 ± 13.6 years, and mean (± standard deviation) serum fTST level of 13.0 ± 6.1 pg/mL. Fifteen (21.1%) men had hypogonadism based on a fTST <8.5 pg/mL. Serum fTST levels significantly decreased with age (−0.216 pg/mL/year). Older age and low hemoglobin levels were identified as risk factors for hypogonadism. Conclusion: The men in the study experienced a more rapid decline in fTST levels with age than men in the general population (−0.161 pg/mL/year). Serum fTST levels in men with HIV infection should be monitored, especially in older men and those with low hemoglobin levels.

scholarly journals Non-alcoholic fatty liver disease in polycystic ovary syndrome women

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Young Bin Won ◽  
Seok Kyo Seo ◽  
Bo Hyon Yun ◽  
SiHyun Cho ◽  
Young Sik Choi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Fatty Liver ◽  
Liver Enzyme ◽  
Fatty Liver Disease ◽  
Polycystic Ovary ◽  
Insulin Level ◽  
University Hospital ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

AbstractTo evaluate risk factors leading to non-alcoholic fatty liver disease (NAFLD) occurrence in polycystic ovarian syndrome (PCOS) women. A retrospective cohort study of a total of 586 women diagnosed with PCOS aged 13–35 years at the gynecology department at a university hospital was done to evaluate PCOS phenotype, metabolic syndrome (MetS) diagnosis, body composition, insulin sensitivity, sex hormones, lipid profile, liver function, and transient elastography (TE). In PCOS women with NAFLD compared to those without, MetS diagnosis (Hazard ratio [HR] 5.6, 95% Confidence interval [CI] 2.2–14.4, p < 0.01) and hyperandrogenism (HA) (HR 4.4, 95% CI 1.4–13.4, p = 0.01) were risk factors significantly associated with subsequent NAFLD occurrence, whereas 2-h insulin level in 75 g glucose tolerance test (GTT) (HR 1.2, 95% CI 0.5–2.5, p = 0.70) and body mass index (BMI) > 25 kg/m2 (HR 2.2, 95% CI 0.6–8.0, p = 0.24) was not. Among NAFLD patients who underwent TE, a higher number of MetS components indicated a worse degree of fibrosis and steatosis. MetS diagnosis and HA at PCOS diagnosis were risk factors associated with NAFLD, while 2-h insulin level in 75 g GTT and obesity were not. Although elevated aspartate aminotransferase levels were significant for NAFLD risk, liver enzyme elevations may not be present until late liver damage. Further prospective studies of PCOS women with MetS or HA are warranted to determine whether patients without liver enzyme elevations should undergo preemptive liver examinations.

Delayed onset bleed after percutaneous kidney biopsy: is it the same as early bleed?

2021 ◽  
pp. 028418512098881
Author(s):  
Dharmendra Bhadauria ◽  
Leena Jose ◽  
Ravi Kushwaha ◽  
Anupma Kaul ◽  
Raghu Nandan ◽  
...  
Keyword(s):  
Major Bleeding ◽  
Kidney Biopsy ◽  
Tertiary Care ◽  
North India ◽  
Bleeding Complications ◽  
Control Group ◽  
Blood Transfusions ◽  
Delayed Bleeding ◽  
Delayed Onset ◽  
Good Patient Outcome

Background While the majority of bleeding complications after a percutaneous kidney biopsy (PKB) occur early (≤24 h), delayed onset bleeding complications (>24 h) have been rarely reported and can be catastrophic for the patient. Purpose To describe the incidence, risk factors, and outcomes of delayed bleeding complications after PKB. Material and Methods We retrospectively studied native and graft kidney biopsies in patients who developed delayed bleeding complications (>24 h) after the biopsy performed in the Department of Nephrology and Renal Transplantation of a tertiary care medical institution in north India between January 2014 to December 2018. Results Of the 4912 renal biopsies reviewed, 20 patients (16 men, 4 women; 0.40%) had a delayed biopsy bleeding complication. Of these patients, 95% had major bleeding complications requiring blood transfusions and 85% needed intervention like gelfoam/coil embolization. Despite intervention, one patient (5%) had mortality due to complications of bleeding and sepsis. When compared to a control group of patients with early biopsy bleed, patients with the delayed biopsy bleed had similar demographic and clinical profiles except for higher pre-biopsy hemoglobin and lower systolic and diastolic blood pressure. Conclusion A post-PKB delayed onset bleed is not uncommon, and the vast majority of these patients had major bleeding complications requiring blood transfusions and/or intervention like embolization. They had a similar demographic and clinical profile presentation as early bleed patients. Meticulous outpatient monitoring and patient education after discharge may be useful to detect this complication promptly and to intervene early to have good patient outcome.

scholarly journals Assessing burden, risk factors, and perceived impact of uterine fibroids on women’s lives in rural Haiti: implications for advancing a health equity agenda, a mixed methods study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Christophe Millien ◽  
Anatole Manzi ◽  
Arlene M. Katz ◽  
Hannah Gilbert ◽  
Mary C. Smith Fawzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mixed Methods ◽  
Black Women ◽  
Uterine Fibroids ◽  
Mixed Methods Study ◽  
University Hospital ◽  
Gynecologic Surgery ◽  
Cross Sectional ◽  
Women's Lives

Abstract Background Uterine fibroids, the most common cause of gynecologic surgery, have a reported cumulative incidence of 59% among Black women in the U.S. Uterine fibroids negatively impact the quality of women’s lives. No study has been found in the literature about fibroids in Haiti. We conducted a mixed methods study to assess the burden and risk factors of uterine fibroids, as well as their effects on women’s quality of life. Methods A convergent mixed methods study was conducted between October 1, 2019 and January 31, 2020 at MUH’s (Mirebalais University Hospital) OB-GYN outpatient department. Quantitatively, in a cross-sectional study 211 women completed consecutively a structured questionnaire. In-depth interviews with 17 women with fibroids and 7 family members were implemented for the qualitative component. Descriptive statistics were calculated for clinical and social demographic variables. Logistic regression was performed to examine associations between fibroids and related risk factors. An inductive thematic process was used to analyze the qualitative data. A joint display technique was used to integrate the results. Results Of 193 women analyzed 116 had fibroids (60.1%). The mean age was 41.3. Anemia was the most frequent complication— 61 (52.6%). Compared to women without uterine fibroids, factors associated with uterine fibroids included income decline (AOR = 4.7, 95% CI: 2.1–10.9, p = < 0.001), excessive expenses for transport (AOR = 4.4, 95% CI: 1.6–12.4, p = 0.005), and family history with uterine fibroids (AOR = 4.6, 95% CI: 1.6–13.6, p = 0.005). In contrast, higher level of education and micro polycystic ovarian syndrome were associated with lower prevalence (AOR = 0.3, 95% CI: 0.1–0.9, p = 0.021) and (AOR = 0.2, 95% CI: 0.1–0.97, p = 0.044), respectively. The qualitative findings delineate how contextual factors such as health system failures, long wait times, gender inequality and poverty negatively affect the quality of women’s lives. The poverty cycle of uterine fibroids emerged. Conclusions A vicious cycle of poverty negatively impacts access to care for uterine fibroids in Haiti. Health insurance, social support, and income generating activities may be keys to promote social justice through access to adequate care for women with uterine fibroids in Haiti.

scholarly journals Is There an Association between Childhood Obesity and Pediatric Kidney Stone Disease? A Literature Review

Uro ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 108-117
Author(s):  
Henry J. Paiste ◽  
Luke Moradi ◽  
Dean G. Assimos ◽  
Kyle D. Wood ◽  
Pankaj P. Dangle
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Pediatric Obesity ◽  
Stone Disease ◽  
Renal Diseases ◽  
Obesity Epidemic ◽  
Pediatric Urolithiasis ◽  
Stone Formers ◽  
Causal Pathway ◽  
Associated Risk Factors

Objectives: To examine the most recent literature and published science in determining any and all possible associations between pediatric obesity and pediatric urolithiasis. Methods: Retrospective literature review of pediatric stone formers with diagnosed stone disease and all associated risk factors. Peer-reviewed, published manuscripts from the past several decades were analyzed for risk factors associated with pediatric obesity such as diet, hypertension, and renal diseases. Comparing the pediatric obesity literature with the pediatric stone forming literature, any associations and correlations were derived and analyzed. Results: Despite the existing evidence that obesity is linked to stones in adults, the evidence remains unclear whether obesity plays a role in children. Nutritional discrepancies, in the setting of the obesity epidemic, have been shown to alter the risk profile of pediatric patients. Consistent with the published literature, and lack of consistent correlation with obesity and stone disease, is the knowledge that age, gender, geography, and climate may all play a role in the onset of pediatric obesity and may also be on the causal pathway toward pediatric urolithiasis. Conclusion: The manuscript demonstrates that there are a number of risk factors, congenital or acquired, that are associated with pediatric obesity. The mechanisms responsible for these associations may be on the causal pathway toward childhood urolithiasis. These mechanisms that underlie these associations need to be further investigated.

scholarly journals The Prevalence and Clinical Significance of Anaerobic Bacteria in Major Liver Resection

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 139
Author(s):  
Jens Strohäker ◽  
Sophia Bareiß ◽  
Silvio Nadalin ◽  
Alfred Königsrainer ◽  
Ruth Ladurner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anaerobic Bacteria ◽  
Positive Culture ◽  
Infectious Complications ◽  
University Hospital ◽  
Clinical Role ◽  
Liver Resections ◽  
Management Of Complications ◽  
Anaerobic Infections ◽  
Major Hepatectomies

(1) Background: Anaerobic infections in hepatobiliary surgery have rarely been addressed. Whereas infectious complications during the perioperative phase of liver resections are common, there are very limited data on the prevalence and clinical role of anaerobes in this context. Given the risk of contaminated bile in liver resections, the goal of our study was to investigate the prevalence and outcome of anaerobic infections in major hepatectomies. (2) Methods: We retrospectively analyzed the charts of 245 consecutive major hepatectomies that were performed at the department of General, Visceral, and Transplantation Surgery of the University Hospital of Tuebingen between July 2017 and August 2020. All microbiological cultures were screened for the prevalence of anaerobic bacteria and the patients’ clinical characteristics and outcomes were evaluated. (3) Results: Of the 245 patients, 13 patients suffered from anaerobic infections. Seven had positive cultures from the biliary tract during the primary procedure, while six had positive culture results from samples obtained during the management of complications. Risk factors for anaerobic infections were preoperative biliary stenting (p = 0.002) and bile leaks (p = 0.009). All of these infections had to be treated by intervention and adjunct antibiotic treatment with broad spectrum antibiotics. (4) Conclusions: Anaerobic infections are rare in liver resections. Certain risk factors trigger the antibiotic coverage of anaerobes.

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