Vrste biopsija bubrega, komplikacije metode i prikaz vlastitih rezultata

professional thesis

• Title (english): Kidney Biopsy Types, Complications and Outcomes- Our Experience
• Author: Bojana Gardijan
• Mentor: Mladen Knotek (mentor)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2020-12-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

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.
725 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 eGFR<30ml/min/1.73m2 desmopressin was administered.
Patients were observed for 6h before discharge, with a CBC and urine test after 4h.
Major complications were haemorrhage requiring therapeutic intervention or
transfusion. Minor complications were significant reduction in 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 yrs.
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 pts. Average Hb decline was
4.2±6.3 g/L. In 10.1% pts 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 prebiopsy 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. It remains
a possibility in low-risk patients. In other patients it should be done in the hospital
setting due to possibly serious complications.

• Keywords: kidney biopsy; safety; kidney disease; desmopressin
• Language: english
• URN:NBN: urn:nbn:hr:105:820707
• Study programme: Title: Nephrology; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra nefrologije (sveučilišni/a magistar/magistra nefrologije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-14 11:24:41