scholarly journals Adequacy and complication rates of percutaneous renal biopsy with 18- vs. 16-gauge needles in native kidneys in Chinese individuals.

2019 ◽  
Author(s):  
Weiji Xie ◽  
Jing Xu ◽  
Yi Xie ◽  
Zhijun Lin ◽  
Xiaochang Xu ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Immunofluorescence Microscopy ◽  
Complication Rates ◽  
Gross Hematuria ◽  
Pathological Classification ◽  
Percutaneous Renal Biopsy ◽  
Significant Difference ◽  
Group 2 ◽  
Perinephric Hematoma

Abstract Background The study aims to compare the adequacy, complication rate and pathological classification when using 18G vs. 16G needles to perform renal biopsy with ultrasound-guidedance on native kidneys in Chinese individuals.Methods We retrospectively analyzed the number of glomeruli, adequate sample rates, complication rates and pathological classification in 270 patients with the use of 18G or 16G needles from January 2011 to May 2017 and verified whether the needle gauge affected the disease diagnosis.Results A total of 270 kidney biopsies were performed. Among them,72 were performed with 18G needles, and 198 were performed with 16G needles. There was no difference in the number of glomeruli under light microscope using 18G relative to 16G needles (24±11 vs. 25±11, p=0.265), whereas more glomeruli were found in the 16G group than in the 16G group using immunofluorescence microscopy (3±2 vs. 5±3, p<0.05). There was no significant difference in the adequate sample rates between the 18G group and the 16G group (90.28% vs. 93.94%, p=0.298). Minor complications including the incidence of lumbar or abdominal pain (4.17% vs. 7.07%, p = 0.57), gross hematuria (4.17% vs. 3.54%, p = 0.729), and perinephric hematoma without symptoms (4.17% vs. 1.52%, p = 0.195), were not significantly different between the 18G and 16G groups. In the 16G group, 2 cases of serious complications occurred: severe gross hematuria requiring blood transfusion and retroperitoneal hematoma requiring surgery. No serious complications were observed in the 18G group, although there was no significant difference in serious complications rates between the 18G and 16G groups (0% vs. 1.02%, p = 1).Conclusion There was no significant difference in the number of glomeruli, adequate sample rates, or complication rates when using 18G or 16G needles to perform renal biopsy, and the use of an 18G needle with a smaller diameter did not affect the pathological diagnosis or classification of IgA nephropathy and lupus nephritis.

scholarly journals Adequacy and complication rates of percutaneous renal biopsy with 18- vs. 16-gauge needles in native kidneys in Chinese individuals.

2020 ◽  
Author(s):  
Weiji Xie ◽  
Jing Xu ◽  
Yi Xie ◽  
Zhijun Lin ◽  
Xiaochang Xu ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Immunofluorescence Microscopy ◽  
Disease Diagnosis ◽  
Complication Rates ◽  
Gross Hematuria ◽  
Pathological Classification ◽  
Significant Difference ◽  
Group 2 ◽  
Perinephric Hematoma

Abstract Background: The study aims to compare the adequacy, complication rate and pathological classification when using 18G vs. 16G needles to perform renal biopsy with ultrasound-guidedance on native kidneys in Chinese individuals.Methods: We retrospectively analyzed the number of glomeruli, adequate sample rates, complication rates and pathological classification in 270 patients with the use of 18G or 16G needles from January 2011 to May 2017 and verified whether the needle gauge affected the disease diagnosis.Results: A total of 270 kidney biopsies were performed. Among them,72 were performed with 18G needles, and 198 were performed with 16G needles. There was no difference in the number of glomeruli under light microscope using 18G relative to 16G needles (24±11 vs. 25±11, p=0.265）, whereas more glomeruli were found in the 16G group than in the 16G group using immunofluorescence microscopy (3±2 vs. 5±3, p<0.05). There was no significant difference in the adequate sample rates between the 18G group and the 16G group (90.28% vs. 93.94%, p=0.298). Minor complications including the incidence of lumbar or abdominal pain (4.17% vs. 7.07%, p = 0.57), gross hematuria (4.17% vs. 3.54%, p = 0.729), and perinephric hematoma without symptoms (4.17% vs. 1.52%, p = 0.195), were not significantly different between the 18G and 16G groups. In the 16G group, 2 cases of serious complications occurred: severe gross hematuria requiring blood transfusion and retroperitoneal hematoma requiring surgery. No serious complications were observed in the 18G group, although there was no significant difference in serious complications rates between the 18G and 16G groups (0% vs. 1.02%, p = 1).Conclusion: There was no significant difference in the number of glomeruli, adequate sample rates, or complication rates when using 18G or 16G needles to perform renal biopsy, and the use of an 18G needle with a smaller diameter did not affect the pathological diagnosis or classification of IgA nephropathy and lupus nephritis.

scholarly journals Adequacy and complication rates of percutaneous renal biopsy with 18- vs. 16-gauge needles in native kidneys in Chinese individuals.

2020 ◽  
Author(s):  
Weiji Xie ◽  
Jing Xu ◽  
Yi Xie ◽  
Zhijun Lin ◽  
Xiaochang Xu ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Disease Diagnosis ◽  
Complication Rates ◽  
Gross Hematuria ◽  
Pathological Classification ◽  
Percutaneous Renal Biopsy ◽  
Significant Difference ◽  
Group 2 ◽  
Perinephric Hematoma ◽  
Different Diameters

Abstract Background: Percutaneous renal biopsy (PRB) is the primary biopsy technique and it was used by 16G needles or 18G needles in China, but there is controversy about the effect and safety of the two different diameters. The study aims to compare the adequacy, complication rate and pathological classification when using 18G vs. 16G needles to perform renal biopsy with ultrasound-guidedance on native kidneys in Chinese individuals.Methods: We retrospectively analyzed the number of glomeruli, adequate sample rates, complication rates and pathological classification in 270 patients with the use of 18G or 16G needles from January 2011 to May 2017 and verified whether the needle gauge affected the disease diagnosis.Results: A total of 270 kidney biopsies were performed. Among them,72 were performed with 18G needles, and 198 were performed with 16G needles. There was no difference in the number of glomeruli under light microscope using 18G relative to 16G needles (24±11 vs. 25±11, p=0.265）, whereas more glomeruli were found in the 16G group than in the 16G group using immunofluorescence microscopy (3±2 vs. 5±3, p<0.05). There was no significant difference in the adequate sample rates between the 18G group and the 16G group (90.28% vs. 93.94%, p=0.298). Minor complications including the incidence of lumbar or abdominal pain (4.17% vs. 7.07%, p = 0.57), gross hematuria (4.17% vs. 3.54%, p = 0.729), and perinephric hematoma without symptoms (4.17% vs. 1.52%, p = 0.195), were not significantly different between the 18G and 16G groups. In the 16G group, 2 cases of serious complications occurred: severe gross hematuria requiring blood transfusion and retroperitoneal hematoma requiring surgery. No serious complications were observed in the 18G group, although there was no significant difference in serious complications rates between the 18G and 16G groups (0% vs. 1.02%, p = 1).Conclusion: There was no significant difference in the number of glomeruli, adequate sample rates, or complication rates when using 18G or 16G needles to perform renal biopsy, and the use of an 18G needle with a smaller diameter did not affect the pathological diagnosis or classification of IgA nephropathy and lupus nephritis.

scholarly journals Adequacy and complication rates of percutaneous renal biopsy on native kidneys in Chinese with 18- vs. 16-gauge needles

2019 ◽  
Author(s):  
Weiji Xie ◽  
Jing Xu ◽  
Yi Xie ◽  
Zhijun Lin ◽  
Xiaochang Xu ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Immunofluorescence Microscopy ◽  
Complication Rates ◽  
Ultrasound Guided ◽  
Gross Hematuria ◽  
Pathological Classification ◽  
Significant Difference ◽  
Diagnosis And Classification ◽  
Perinephric Hematoma

Abstract Aim: The study aims to compare the adequacy, complication and pathological classification rates of using 18G vs. 16G needles to perform renal biopsy with ultrasound-guided on native kidneys in Chinese. Methods: We retrospectively analyzed the number of glomeruli, adequate sample rates, complication rates and pathological classification in 270 patients who were used by 18G or 16G needles separately from January, 2011 to May, 2017，and verified whether the needle gauge affect the diagnosis of the disease. Results: A total of 270 kidney biopsies were performed. Among them :72 were with 18G needles, and 198 were with16G needles. There was no difference in the number of glomeruli count under light microscope using 18G relative to 16G needles（24±11vs25±11，p=0.265）, whereas more glomeruli count were found for the 16G group using immunofluorescence microscopy(3±2 vs 5±3， p＜0.05).There was no significant difference in the adequate sample rates between 18G group and 16G group (90.28%vs93.94%, p=0.298). Minor complications including the incidence of lumbar or abdominal pain (4.17% vs 7.07%, p = 0.57), gross hematuria (4.17% vs 3.54%, p = 0.729), and perinephric hematoma without symptoms (4.17% vs1.52%, p = 0.195) were not significantly different for 18G vs 16G group. In 16G group, there was 2 cases of serious complications occurred, including severe gross hematuria requiring blood transfusion, and retroperitoneal hematoma requiring surgery. No serious complications were observed in the 18G group, even although there was no significant difference in serious complications rates between the 18G and 16G group (0% vs 1.02%，p = 1). Conclusion: There was no significant difference in the number of glomeruli, adequate sample rates, and complication rates of using the 18G and 16G needles to perform renal biopsy, and the 18G needle with smaller diameter did not affect the pathological diagnosis and classification of IgA nephropathy and lupus nephritis.

scholarly journals Percutaneous Renal Biopsy: Comparison of Blind and Real-time Ultrasound Guided Technique

2018 ◽  
Vol 16 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Anil Pokhrel ◽  
Rajendra Kumar Agrawal ◽  
Anil Baral ◽  
Ajaya Rajbhandari ◽  
Rajani Hada
Keyword(s):  
Renal Biopsy ◽  
Real Time ◽  
Randomized Study ◽  
Bleeding Complications ◽  
Renal Diseases ◽  
Ultrasound Guided ◽  
Macroscopic Hematuria ◽  
Percutaneous Renal Biopsy ◽  
Significant Difference ◽  
Perinephric Hematoma

Background: Percutaneous renal biopsy is performed for diagnosis and prediction of prognosis of renal diseases. Adequacy of tissue and clinically significant bleeding are the main issues of the procedure. We aimed to compare these issues in renal biopsy by blind and real time ultrasound guided technique.Methods: It was a cross sectional, randomized study conducted between June 2016 to December 2016. In blind technique, marking for biopsy was done by ultrasound. Two attempts were performed for all and more if tissue was inadequate. Patients kept in bed rest for 24 hours, observed for post procedure hematuria and ultrasound done at 6 hours and 24 hours to diagnose perinephric hematoma.Results: Total 75 biopsies (blind = 37 and Ultrasound -guided = 38) were evaluated. Blind and Ultrasound-guided technique had significant difference of number of attempt (mean±SD) 2.4±0.6 and 2.1±0.3 (p<0.01) respectively with no difference of number of glomeruli in light microscopy. Bleeding complications were macroscopic hematuria (11(30%)vs15(40%)) and perinephric hematoma ( 5(13.5%)vs3(7.9%)) in blind and Ultrasound-guided technique respectively with no significant difference. Those patients who developed perinephric hematoma was observed in all at 6 hours.Conclusions: Ultrasound-guided technique of percutaneous renal biopsy is superior with fewer attempts and equivalent in adequacy of tissue and bleeding complication than blind technique.

scholarly journals Safety of Renal Biopsy by Physicians with Short Nephrology Experience

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 474
Author(s):  
Kenta Torigoe ◽  
Kumiko Muta ◽  
Kiyokazu Tsuji ◽  
Ayuko Yamashita ◽  
Shinichi Abe ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Biopsy ◽  
Renal Diseases ◽  
Complication Rates ◽  
Artery Embolization ◽  
Clinical Nephrology ◽  
Percutaneous Renal Biopsy ◽  
Artery Embolism ◽  
Renal Artery Embolization ◽  
Biopsy Complications

Percutaneous renal biopsy is an essential tool for diagnosing various renal diseases; however, little is known about whether renal biopsy performed by physicians with short nephrology experience is safe in Japan. This study included 238 patients who underwent percutaneous renal biopsy between April 2017 and September 2020. We retrospectively analyzed the frequency of post-renal biopsy complications (hemoglobin decrease of ≥10%, hypotension, blood transfusion, renal artery embolization, nephrectomy and death) and compared their incidence among physicians with varied experience in nephrology. After renal biopsy, a hemoglobin decrease of ≥10%, hypotension and transfusion occurred in 13.1%, 3.8% and 0.8% of patients, respectively. There were no cases of post-biopsy renal artery embolism, nephrectomy, or death. The composite complication rate was 16.0%. The incidence of post-biopsy complications was similar between physicians with ≥3 years and <3 years of clinical nephrology experience (12.5% vs. 16.8%, p = 0.64). Furthermore, the post-biopsy composite complication rates were similar between physicians with ≥6 months and <6 months of clinical nephrology experience (16.3% vs. 15.6%, p > 0.99). Under attending nephrologist supervision, a physician with short clinical nephrology experience can safely perform renal biopsy.

PERCUTANEOUS RENAL BIOPSY IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 30 (2) ◽  
pp. 287-296
Author(s):  
W. F. Dodge ◽  
C. W. Daeschner ◽  
J. C. Brennan ◽  
H. S. Rosenberg ◽  
L. B. Travis ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Clinical Importance ◽  
Renal Diseases ◽  
Renal Lesion ◽  
Bleeding Tendency ◽  
Percutaneous Renal Biopsy ◽  
The One ◽  
Selection Of

Since 1951, when the percutaneous renal biopsy was introduced as an adjunctive method for study of patients with renal disease, reports of some 4,000 kidney biopsies have appeared in the literature. Only about 250 of these, however, have been performed in children. A biopsy specimen containing 5 to 10 glomeruli has been reported to be adequate for interpretation and to be representative of the total renal parenchyma in 84% of the cases with diffuse renal disease. Using a biopsy technique similar to that described by Kark, we have obtained an adequate specimen in 92% of 205 kidney biopsies performed in 168 children with diffuse renal diseases. Seven deaths have been previously reported in the literature. The circumstances surrounding the death of these seven patients and of the one death that occurred in our series are described. Perirenal hematoma has had a reported incidence of 0.4%. It has been our experience, as well as that of the other investigators, that if blood boss is replaced, the patient has an otherwise uneventful course and the mass subsequently disappears. Gross hematuria has had a reported incidence of 5.2%. Microscopic hematuria, lasting for 6 to 12 hours after biopsy, has been found to be the rule rather than the exception. The complications which have occurred have been associated with bleeding, and therefore a careful history concerning bleeding tendency and a study of the clotting mechanism is essential if the risk of needle renal biopsy is to be minimized. In addition to a bleeding tendency or defect in clotting mechanism, most investigators are agreed that the presence of only one kidney or an uncooperative patient are absolute contraindications to renal biopsy. The renal biopsy is primarily, at present, an additional and most useful investigative tool in the elucidation of the pathogenesis, natural history (by serial studies) and effectiveness of specific therapy upon the various renal diseases. It is of practical clinical importance in the selection of those patients with the nephrotic syndrome in whom glucocorticoid therapy is likely to be beneficial or the patient with anuria whose renal lesion is probably reversible with time; and, as a guide to the effectiveness of therapy in patients with pyelonephritis or lupus nephritis. It is not a technique that can be recommended for general or casual use. A classification of the pathohistobogic findings of diffuse glomerulonephritis, patterned after Ellis, is presented and discussed. This classification will be used in the description and discussion of various renal diseases and systemic diseases with associated nephritis in the three subsequent papers.

scholarly journals Renal access in PNL under sonographic guidance: Do we really need to insert an open end ureteral catheter in dilated renal systems? A prospective randomized study

2017 ◽  
Vol 89 (3) ◽  
pp. 226
Author(s):  
Bilal Eryildirim ◽  
Murat Tuncer ◽  
Emre Camur ◽  
Fatih Ustun ◽  
Fatih Tarhan ◽  
...  
Keyword(s):  
Randomized Study ◽  
Total Duration ◽  
Renal Stones ◽  
Complication Rates ◽  
Nephrostomy Tube ◽  
Ureteral Catheter ◽  
Sonographic Guidance ◽  
Hospitalization Period ◽  
Significant Difference ◽  
Group 2

Purpose: To evaluate the true necessity of open end ureteral catheter insertion in patients with moderate to severe pelvicalyceal system dilation treated with percutaneous nephrolithotomy (PNL) under sonographic guidance. Patients and methods: 50 cases treated with PNL under sonographic guidance in prone position for solitary obstructing renal stones were evaluated. Patients were randomly divided into two groups; Group 1: Patients in whom a open end ureteral catheter was inserted prior to the procedure; Group 2: Patients receiving no catheter before PNL. In addition to the duration of the procedure as a whole and also all relevant stages as well, radiation exposure time, hospitalization period, mean nephrostomy tube duration, mean drop in Hb levels and all intra and postoperative complications have been evaluated. Results: Mean size of the stones was 308.5 ± 133.2 mm2. Mean total duration of the PNL procedure in cases with open end ureteral catheter was significantly longer than the other cases (p < 0.001). Evaluation of the outcomes of the PNL procedures revealed no statistically significant difference between two groups regarding the stone-free rates (86% vs 84%). Additionally, there was no significant difference with respect to the duration of nephrostomy tube, hospitalization period and secondary procedures needed, complication rates as well as the post-operative Hb drop levels in both groups (p = 0.6830). Conclusions: Our results indicate that the placement of an open end ureteral catheter prior to a PNL procedure performed under sonographic access may not be indicated in selected cases presenting with solitary obstructing renal pelvic and/or calyceal stones.

scholarly journals Life-Threatening Complications Following Percutaneous Ultrasound-Guided Renal Biopsy: a Rare Case Report

10.3823/2292 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Yuan-Hung Lo ◽  
Po-Jen Hsiao ◽  
Szu-Han Chiu ◽  
Kun-Lin Wu ◽  
Che-Fu Chang ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Hypovolemic Shock ◽  
Bleeding Complications ◽  
Ultrasound Guided ◽  
Basic Tool ◽  
Gross Hematuria ◽  
Percutaneous Renal Biopsy ◽  
Major Complications ◽  
Rare Case Report ◽  
Life Threatening

Ultrasound-guided percutaneous renal biopsy has been a basic tool for the diagnosis of kidney disease, but minor and major complications cannot be completely avoided. Major complications including gross hematuria, renal hematoma and arteriovenous fistula, and usually develop within 24 hours after renal biopsy. We present an educational case of female having major bleeding complications after renal biopsy with unusual clinical courses. The patient developed hypovolemic shock at 48 hours after renal biopsy along with perirenal hematoma and hemothorax.   The case highlight the need to remain the major complications in mind for physicians. Key words: Hemothorax, renal biopsy.

scholarly journals Adequacy and complication rates of percutaneous renal biopsy with 18- vs. 16-gauge needles in native kidneys in Chinese individuals

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Weiji Xie ◽  
Jing Xu ◽  
Yi Xie ◽  
Zhijun Lin ◽  
Xiaochang Xu ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Complication Rates ◽  
Percutaneous Renal Biopsy

Presurgical treatment with somatostatin analogs in patients with acromegaly: effects on the remission and complication rates

2006 ◽  
Vol 104 (6) ◽  
pp. 899-906 ◽  
Author(s):  
Marco Losa ◽  
Pietro Mortini ◽  
Laura Urbaz ◽  
Paolo Ribotto ◽  
Tristana Castrignanò ◽  
...  
Keyword(s):  
Tumor Size ◽  
Surgical Outcome ◽  
Somatostatin Analogs ◽  
Preoperative Treatment ◽  
Complication Rates ◽  
Surgery Group ◽  
Significant Difference ◽  
Group 2 ◽  
Matching Criteria ◽  
Group 1

Object The question of whether preoperative therapy with somatostatin analogs can improve surgical outcome in acromegaly has not been definitively answered. In this paper, the authors report the effects of preoperative treatment with somatostatin analogs in a large sample of patients with acromegaly. Methods Between 1990 and 2003, 399 consecutive patients with acromegaly underwent surgery at the Istituto Scientifico San Raffaele. Thirty-three patients who had previously undergone surgery or radiation treatment, 48 patients treated with somatostatin analogs for fewer than 3 months, and patients who had stopped therapy for too long a time before surgery were excluded from the study. One hundred forty-three patients who had received somatostatin analogs prior to surgery (Group 1) were randomly matched to 143 patients who had never been treated with somatostatin analogs (Group 2). Matching criteria were tumor size and invasiveness into the cavernous sinus. Before surgery, Group 1 patients showed reduction of growth hormone levels to less than 50% of baseline in 64% of cases, but insulin-like growth factor–I was normalized in only 19.5%. Surgical remission occurred in 81 Group 1 patients (56.6%) and in 91 Group 2 patients (63.6%; p = 0.28). No significant difference in the remission rate was observed when cases were analyzed according to tumor size or invasiveness. Logistic regression analysis confirmed that pretreatment with somatostatin analogs was not associated with surgical outcome. Surgical morbidity was mild and similar in Group 1 and Group 2 patients (7 and 5.6%, respectively; p = 0.81). Surgical remission and complication rates in patients with acromegaly who received treatment with somatostatin analogs prior to surgery were not significantly different from those of matched patients who did not receive these agents. Conclusions At present, the routine use of presurgical therapy with somatostatin analogs for patients with acromegaly cannot be recommended.

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