Risk of complications of ultrasound-guided renal biopsy for adult and pediatric patients with systemic lupus erythematosus
Objective The objective of this paper is to identify the risk of complications of real-time ultrasound-guided renal biopsy in adult and pediatric patients with systemic lupus erythematosus (SLE). Materials and methods This retrospective study examined outcomes of 296 renal biopsy procedures in 275 S...
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| Veröffentlicht in: | Lupus 2018-04, Vol.27 (5), p.828-836 |
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| creator | Sun, Y S Sun, I T Wang, H K Yang, A H Tsai, C Y Huang, C J Huang, D F Lai, C C |
| description | Objective
The objective of this paper is to identify the risk of complications of real-time ultrasound-guided renal biopsy in adult and pediatric patients with systemic lupus erythematosus (SLE).
Materials and methods
This retrospective study examined outcomes of 296 renal biopsy procedures in 275 SLE patients. Imaging-confirmed symptomatic hematoma was regarded as a major complication when intervention (blood transfusion, angiographic embolization, or surgery) was required or as a minor complication otherwise. Clinical and laboratory data were compared between groups with or without complications after initial or subsequent renal biopsy. Binary logistic regressions were used to evaluate complication risk of initial renal biopsy.
Results
Overall complication rate of initial renal biopsy was 8.7% (major: 2.9%, minor: 5.8%). Three patients expired from pulmonary hemorrhage, thrombotic microangiopathy, and pneumonia. Pediatric SLE patients tended to have a higher rate of major complications (12.5%) than adult patients (2.3%). According to multivariable analysis results, elevated serum creatinine (SCr) level (OR 1.45; 95% CI 1.17–1.81 per mg/dl), prolonged prothrombin time (PT) (OR 2.2; 95% CI 1.05–4.62 per second), and thrombocytopenia (OR 4.3; 95% CI 1.56–11.9) increased overall complication risk of initial renal biopsy. Age |
| doi_str_mv | 10.1177/0961203317751048 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1989535662</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0961203317751048</sage_id><sourcerecordid>2424752496</sourcerecordid><originalsourceid>FETCH-LOGICAL-c407t-3d68961a5a3440e46aaf596de2db85196bc355c460268092df88916bf60119c83</originalsourceid><addsrcrecordid>eNp1kc1LHTEUxUNpqa_q3pUE3HQzbb5nshTphyAIRddDJslo7MxkzE2Q51_fPJ62IHSVcO7vnsvhIHRCyRdK2_Yr0Yoywnn9S0pE9w5tqGjbpursPdrsxs1ufoA-ATwQQjjV6iM6YJqTCpINev4V4DeOI7ZxXqdgTQ5xgZ1QppwMxLK45q4E5x1OfjETHkJcYYvHmLBxFcJmcXj1LpicgsVrdfBLBvwU8j2GLWQ_V3kqawHs0zbf-9nkCAWO0IfRTOCPX95DdPv9283Fz-bq-sflxflVYwVpc8Od6moOIw0XgnihjBmlVs4zN3Sy5hksl9IKRZjqiGZu7DpN1TAqQqm2HT9En_e-a4qPxUPu5wDWT5NZfCzQU91pyaVSrKJnb9CHWFJNDT0TTLSSCa0qRfaUTREg-bFfU5hN2vaU9Lte-re91JXTF-MyzN79XXgtogLNHgBz5_9d_a_hH1wjlck</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2424752496</pqid></control><display><type>article</type><title>Risk of complications of ultrasound-guided renal biopsy for adult and pediatric patients with systemic lupus erythematosus</title><source>Access via SAGE</source><creator>Sun, Y S ; Sun, I T ; Wang, H K ; Yang, A H ; Tsai, C Y ; Huang, C J ; Huang, D F ; Lai, C C</creator><creatorcontrib>Sun, Y S ; Sun, I T ; Wang, H K ; Yang, A H ; Tsai, C Y ; Huang, C J ; Huang, D F ; Lai, C C</creatorcontrib><description>Objective
The objective of this paper is to identify the risk of complications of real-time ultrasound-guided renal biopsy in adult and pediatric patients with systemic lupus erythematosus (SLE).
Materials and methods
This retrospective study examined outcomes of 296 renal biopsy procedures in 275 SLE patients. Imaging-confirmed symptomatic hematoma was regarded as a major complication when intervention (blood transfusion, angiographic embolization, or surgery) was required or as a minor complication otherwise. Clinical and laboratory data were compared between groups with or without complications after initial or subsequent renal biopsy. Binary logistic regressions were used to evaluate complication risk of initial renal biopsy.
Results
Overall complication rate of initial renal biopsy was 8.7% (major: 2.9%, minor: 5.8%). Three patients expired from pulmonary hemorrhage, thrombotic microangiopathy, and pneumonia. Pediatric SLE patients tended to have a higher rate of major complications (12.5%) than adult patients (2.3%). According to multivariable analysis results, elevated serum creatinine (SCr) level (OR 1.45; 95% CI 1.17–1.81 per mg/dl), prolonged prothrombin time (PT) (OR 2.2; 95% CI 1.05–4.62 per second), and thrombocytopenia (OR 4.3; 95% CI 1.56–11.9) increased overall complication risk of initial renal biopsy. Age < 18 years (OR 8.43; 95% CI 1.21–58.8), thrombocytopenia (OR 16.4; 95% CI 2.44–110.5), and elevated SCr level (OR 1.97; 95% CI 1.36–2.86 per md/dl) increased risk of major complications. Thrombocytopenia, prolonged PT, and elevated SCr level were associated with complications after subsequent renal biopsy (all p = 0.01).
Conclusions
SLE patients, particularly patients under 18 years old or with elevated SCr level, prolonged PT, or thrombocytopenia, have an increased risk of complications after initial or subsequent renal biopsy.</description><identifier>ISSN: 0961-2033</identifier><identifier>EISSN: 1477-0962</identifier><identifier>DOI: 10.1177/0961203317751048</identifier><identifier>PMID: 29301470</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Biopsy ; Blood transfusion ; Creatinine ; Embolization ; Hematoma ; Hemorrhage ; Kidneys ; Lupus ; Patients ; Pediatrics ; Prothrombin ; Surgery ; Systemic lupus erythematosus ; Thrombocytopenia ; Thrombotic microangiopathy ; Ultrasonic imaging ; Ultrasound</subject><ispartof>Lupus, 2018-04, Vol.27 (5), p.828-836</ispartof><rights>The Author(s) 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-3d68961a5a3440e46aaf596de2db85196bc355c460268092df88916bf60119c83</citedby><cites>FETCH-LOGICAL-c407t-3d68961a5a3440e46aaf596de2db85196bc355c460268092df88916bf60119c83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0961203317751048$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0961203317751048$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,782,786,21828,27933,27934,43630,43631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29301470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sun, Y S</creatorcontrib><creatorcontrib>Sun, I T</creatorcontrib><creatorcontrib>Wang, H K</creatorcontrib><creatorcontrib>Yang, A H</creatorcontrib><creatorcontrib>Tsai, C Y</creatorcontrib><creatorcontrib>Huang, C J</creatorcontrib><creatorcontrib>Huang, D F</creatorcontrib><creatorcontrib>Lai, C C</creatorcontrib><title>Risk of complications of ultrasound-guided renal biopsy for adult and pediatric patients with systemic lupus erythematosus</title><title>Lupus</title><addtitle>Lupus</addtitle><description>Objective
The objective of this paper is to identify the risk of complications of real-time ultrasound-guided renal biopsy in adult and pediatric patients with systemic lupus erythematosus (SLE).
Materials and methods
This retrospective study examined outcomes of 296 renal biopsy procedures in 275 SLE patients. Imaging-confirmed symptomatic hematoma was regarded as a major complication when intervention (blood transfusion, angiographic embolization, or surgery) was required or as a minor complication otherwise. Clinical and laboratory data were compared between groups with or without complications after initial or subsequent renal biopsy. Binary logistic regressions were used to evaluate complication risk of initial renal biopsy.
Results
Overall complication rate of initial renal biopsy was 8.7% (major: 2.9%, minor: 5.8%). Three patients expired from pulmonary hemorrhage, thrombotic microangiopathy, and pneumonia. Pediatric SLE patients tended to have a higher rate of major complications (12.5%) than adult patients (2.3%). According to multivariable analysis results, elevated serum creatinine (SCr) level (OR 1.45; 95% CI 1.17–1.81 per mg/dl), prolonged prothrombin time (PT) (OR 2.2; 95% CI 1.05–4.62 per second), and thrombocytopenia (OR 4.3; 95% CI 1.56–11.9) increased overall complication risk of initial renal biopsy. Age < 18 years (OR 8.43; 95% CI 1.21–58.8), thrombocytopenia (OR 16.4; 95% CI 2.44–110.5), and elevated SCr level (OR 1.97; 95% CI 1.36–2.86 per md/dl) increased risk of major complications. Thrombocytopenia, prolonged PT, and elevated SCr level were associated with complications after subsequent renal biopsy (all p = 0.01).
Conclusions
SLE patients, particularly patients under 18 years old or with elevated SCr level, prolonged PT, or thrombocytopenia, have an increased risk of complications after initial or subsequent renal biopsy.</description><subject>Biopsy</subject><subject>Blood transfusion</subject><subject>Creatinine</subject><subject>Embolization</subject><subject>Hematoma</subject><subject>Hemorrhage</subject><subject>Kidneys</subject><subject>Lupus</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Prothrombin</subject><subject>Surgery</subject><subject>Systemic lupus erythematosus</subject><subject>Thrombocytopenia</subject><subject>Thrombotic microangiopathy</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><issn>0961-2033</issn><issn>1477-0962</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kc1LHTEUxUNpqa_q3pUE3HQzbb5nshTphyAIRddDJslo7MxkzE2Q51_fPJ62IHSVcO7vnsvhIHRCyRdK2_Yr0Yoywnn9S0pE9w5tqGjbpursPdrsxs1ufoA-ATwQQjjV6iM6YJqTCpINev4V4DeOI7ZxXqdgTQ5xgZ1QppwMxLK45q4E5x1OfjETHkJcYYvHmLBxFcJmcXj1LpicgsVrdfBLBvwU8j2GLWQ_V3kqawHs0zbf-9nkCAWO0IfRTOCPX95DdPv9283Fz-bq-sflxflVYwVpc8Od6moOIw0XgnihjBmlVs4zN3Sy5hksl9IKRZjqiGZu7DpN1TAqQqm2HT9En_e-a4qPxUPu5wDWT5NZfCzQU91pyaVSrKJnb9CHWFJNDT0TTLSSCa0qRfaUTREg-bFfU5hN2vaU9Lte-re91JXTF-MyzN79XXgtogLNHgBz5_9d_a_hH1wjlck</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Sun, Y S</creator><creator>Sun, I T</creator><creator>Wang, H K</creator><creator>Yang, A H</creator><creator>Tsai, C Y</creator><creator>Huang, C J</creator><creator>Huang, D F</creator><creator>Lai, C C</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20180401</creationdate><title>Risk of complications of ultrasound-guided renal biopsy for adult and pediatric patients with systemic lupus erythematosus</title><author>Sun, Y S ; Sun, I T ; Wang, H K ; Yang, A H ; Tsai, C Y ; Huang, C J ; Huang, D F ; Lai, C C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-3d68961a5a3440e46aaf596de2db85196bc355c460268092df88916bf60119c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Biopsy</topic><topic>Blood transfusion</topic><topic>Creatinine</topic><topic>Embolization</topic><topic>Hematoma</topic><topic>Hemorrhage</topic><topic>Kidneys</topic><topic>Lupus</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Prothrombin</topic><topic>Surgery</topic><topic>Systemic lupus erythematosus</topic><topic>Thrombocytopenia</topic><topic>Thrombotic microangiopathy</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sun, Y S</creatorcontrib><creatorcontrib>Sun, I T</creatorcontrib><creatorcontrib>Wang, H K</creatorcontrib><creatorcontrib>Yang, A H</creatorcontrib><creatorcontrib>Tsai, C Y</creatorcontrib><creatorcontrib>Huang, C J</creatorcontrib><creatorcontrib>Huang, D F</creatorcontrib><creatorcontrib>Lai, C C</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Lupus</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sun, Y S</au><au>Sun, I T</au><au>Wang, H K</au><au>Yang, A H</au><au>Tsai, C Y</au><au>Huang, C J</au><au>Huang, D F</au><au>Lai, C C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of complications of ultrasound-guided renal biopsy for adult and pediatric patients with systemic lupus erythematosus</atitle><jtitle>Lupus</jtitle><addtitle>Lupus</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>27</volume><issue>5</issue><spage>828</spage><epage>836</epage><pages>828-836</pages><issn>0961-2033</issn><eissn>1477-0962</eissn><abstract>Objective
The objective of this paper is to identify the risk of complications of real-time ultrasound-guided renal biopsy in adult and pediatric patients with systemic lupus erythematosus (SLE).
Materials and methods
This retrospective study examined outcomes of 296 renal biopsy procedures in 275 SLE patients. Imaging-confirmed symptomatic hematoma was regarded as a major complication when intervention (blood transfusion, angiographic embolization, or surgery) was required or as a minor complication otherwise. Clinical and laboratory data were compared between groups with or without complications after initial or subsequent renal biopsy. Binary logistic regressions were used to evaluate complication risk of initial renal biopsy.
Results
Overall complication rate of initial renal biopsy was 8.7% (major: 2.9%, minor: 5.8%). Three patients expired from pulmonary hemorrhage, thrombotic microangiopathy, and pneumonia. Pediatric SLE patients tended to have a higher rate of major complications (12.5%) than adult patients (2.3%). According to multivariable analysis results, elevated serum creatinine (SCr) level (OR 1.45; 95% CI 1.17–1.81 per mg/dl), prolonged prothrombin time (PT) (OR 2.2; 95% CI 1.05–4.62 per second), and thrombocytopenia (OR 4.3; 95% CI 1.56–11.9) increased overall complication risk of initial renal biopsy. Age < 18 years (OR 8.43; 95% CI 1.21–58.8), thrombocytopenia (OR 16.4; 95% CI 2.44–110.5), and elevated SCr level (OR 1.97; 95% CI 1.36–2.86 per md/dl) increased risk of major complications. Thrombocytopenia, prolonged PT, and elevated SCr level were associated with complications after subsequent renal biopsy (all p = 0.01).
Conclusions
SLE patients, particularly patients under 18 years old or with elevated SCr level, prolonged PT, or thrombocytopenia, have an increased risk of complications after initial or subsequent renal biopsy.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>29301470</pmid><doi>10.1177/0961203317751048</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biopsy Blood transfusion Creatinine Embolization Hematoma Hemorrhage Kidneys Lupus Patients Pediatrics Prothrombin Surgery Systemic lupus erythematosus Thrombocytopenia Thrombotic microangiopathy Ultrasonic imaging Ultrasound |
| title | Risk of complications of ultrasound-guided renal biopsy for adult and pediatric patients with systemic lupus erythematosus |
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