Adult day-case renal biopsy: a single-centre experience
Despite improvements in safety seen over the last 20 years, percutaneous renal biopsy is still associated with haemorrhagic complications. Due to concerns over delayed bleeding, most nephrologists would advocate overnight observation. Recent evidence in both adult and paediatric populations suggest...
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| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2011-05, Vol.26 (5), p.1559-1563 |
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| creator | CARRINGTON, Christopher P WILLIAMS, Aled GRIFFITHS, David F RILEY, Stephen G DONOVAN, Kieron L |
| description | Despite improvements in safety seen over the last 20 years, percutaneous renal biopsy is still associated with haemorrhagic complications. Due to concerns over delayed bleeding, most nephrologists would advocate overnight observation. Recent evidence in both adult and paediatric populations suggest that in some groups, this is unnecessary. Since 1991, we have provided a day-case renal biopsy service performing 70 such procedures per year. In this study, we present a retrospective analysis of this practice.
A total of 192 patients over a consecutive 3-year period were analysed retrospectively. Patients were selected according to standardized criteria, and biopsy was performed using a modern technique (automated biopsy needles under ultrasound guidance). Complications were identified by examination of case notes and local hospital admission databases, and by telephone interview. Our pathology database was examined for sample adequacy and diagnosis.
There were no delayed complications in the study group with 187 patients (97.4%) being discharged home on the same day. Major complications occurred in five patients (2.6%), all related to bleeding. Of these, two needed radiological intervention to achieve haemostasis. Sufficient tissue for diagnosis was achieved in 97% of cases, with a mean of 47 ± 23 glomeruli obtained per patient. Most biopsies were obtained with ≤ 2 passes (84%).
Our findings show that in selected adult patients, renal biopsy can be performed as a day-case procedure. Given the benefits of day-case strategies in terms of patient and healthcare costs, we advocate increased utilization of this technique. |
| doi_str_mv | 10.1093/ndt/gfq571 |
| format | Article |
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A total of 192 patients over a consecutive 3-year period were analysed retrospectively. Patients were selected according to standardized criteria, and biopsy was performed using a modern technique (automated biopsy needles under ultrasound guidance). Complications were identified by examination of case notes and local hospital admission databases, and by telephone interview. Our pathology database was examined for sample adequacy and diagnosis.
There were no delayed complications in the study group with 187 patients (97.4%) being discharged home on the same day. Major complications occurred in five patients (2.6%), all related to bleeding. Of these, two needed radiological intervention to achieve haemostasis. Sufficient tissue for diagnosis was achieved in 97% of cases, with a mean of 47 ± 23 glomeruli obtained per patient. Most biopsies were obtained with ≤ 2 passes (84%).
Our findings show that in selected adult patients, renal biopsy can be performed as a day-case procedure. Given the benefits of day-case strategies in terms of patient and healthcare costs, we advocate increased utilization of this technique.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfq571</identifier><identifier>PMID: 20858764</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Biopsy - adverse effects ; Biopsy - methods ; Case-Control Studies ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Hospitalization ; Humans ; Intensive care medicine ; Kidney - pathology ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Postoperative Hemorrhage - etiology ; Postoperative Hemorrhage - prevention & control ; Prognosis ; Renal failure ; Retrospective Studies</subject><ispartof>Nephrology, dialysis, transplantation, 2011-05, Vol.26 (5), p.1559-1563</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-f7a5b0152516a1f1ef39b3eb7badeeaf7213acb332869b66ca34b7d9f2421833</citedby><cites>FETCH-LOGICAL-c352t-f7a5b0152516a1f1ef39b3eb7badeeaf7213acb332869b66ca34b7d9f2421833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24212673$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20858764$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CARRINGTON, Christopher P</creatorcontrib><creatorcontrib>WILLIAMS, Aled</creatorcontrib><creatorcontrib>GRIFFITHS, David F</creatorcontrib><creatorcontrib>RILEY, Stephen G</creatorcontrib><creatorcontrib>DONOVAN, Kieron L</creatorcontrib><title>Adult day-case renal biopsy: a single-centre experience</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>Despite improvements in safety seen over the last 20 years, percutaneous renal biopsy is still associated with haemorrhagic complications. Due to concerns over delayed bleeding, most nephrologists would advocate overnight observation. Recent evidence in both adult and paediatric populations suggest that in some groups, this is unnecessary. Since 1991, we have provided a day-case renal biopsy service performing 70 such procedures per year. In this study, we present a retrospective analysis of this practice.
A total of 192 patients over a consecutive 3-year period were analysed retrospectively. Patients were selected according to standardized criteria, and biopsy was performed using a modern technique (automated biopsy needles under ultrasound guidance). Complications were identified by examination of case notes and local hospital admission databases, and by telephone interview. Our pathology database was examined for sample adequacy and diagnosis.
There were no delayed complications in the study group with 187 patients (97.4%) being discharged home on the same day. Major complications occurred in five patients (2.6%), all related to bleeding. Of these, two needed radiological intervention to achieve haemostasis. Sufficient tissue for diagnosis was achieved in 97% of cases, with a mean of 47 ± 23 glomeruli obtained per patient. Most biopsies were obtained with ≤ 2 passes (84%).
Our findings show that in selected adult patients, renal biopsy can be performed as a day-case procedure. Given the benefits of day-case strategies in terms of patient and healthcare costs, we advocate increased utilization of this technique.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Biopsy - adverse effects</subject><subject>Biopsy - methods</subject><subject>Case-Control Studies</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Kidney - pathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Postoperative Hemorrhage - etiology</subject><subject>Postoperative Hemorrhage - prevention & control</subject><subject>Prognosis</subject><subject>Renal failure</subject><subject>Retrospective Studies</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0E1Lw0AQBuBFFFurF3-A5CKCsHY_sruJt1L8goKX3sPsZrZE0iTdTcD--0Za9TSHeeZleAm55eyJs1zOm7Kfb_xOGX5GpjzVjAqZqXMyHZecMsXyCbmK8YsxlgtjLslEsExlRqdTYhblUPdJCXvqIGISsIE6sVXbxf1zAkmsmk2N1GHTB0zwu8NQYePwmlx4qCPenOaMrF9f1st3uvp8-1guVtRJJXrqDSjLuBKKa-Ceo5e5lWiNhRIRvBFcgrNSikznVmsHMrWmzL1IBc-knJGHY2wX2t2AsS-2VXRY19BgO8Qi06nJxHg-ysejdKGNMaAvulBtIewLzoqfmoqxpuJY04jvTrGD3WL5R397GcH9CUB0UPsAjavivxu_E9pIeQCZnHAo</recordid><startdate>20110501</startdate><enddate>20110501</enddate><creator>CARRINGTON, Christopher P</creator><creator>WILLIAMS, Aled</creator><creator>GRIFFITHS, David F</creator><creator>RILEY, Stephen G</creator><creator>DONOVAN, Kieron L</creator><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110501</creationdate><title>Adult day-case renal biopsy: a single-centre experience</title><author>CARRINGTON, Christopher P ; WILLIAMS, Aled ; GRIFFITHS, David F ; RILEY, Stephen G ; DONOVAN, Kieron L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-f7a5b0152516a1f1ef39b3eb7badeeaf7213acb332869b66ca34b7d9f2421833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Biopsy - adverse effects</topic><topic>Biopsy - methods</topic><topic>Case-Control Studies</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Kidney - pathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Postoperative Hemorrhage - etiology</topic><topic>Postoperative Hemorrhage - prevention & control</topic><topic>Prognosis</topic><topic>Renal failure</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CARRINGTON, Christopher P</creatorcontrib><creatorcontrib>WILLIAMS, Aled</creatorcontrib><creatorcontrib>GRIFFITHS, David F</creatorcontrib><creatorcontrib>RILEY, Stephen G</creatorcontrib><creatorcontrib>DONOVAN, Kieron L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CARRINGTON, Christopher P</au><au>WILLIAMS, Aled</au><au>GRIFFITHS, David F</au><au>RILEY, Stephen G</au><au>DONOVAN, Kieron L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adult day-case renal biopsy: a single-centre experience</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2011-05-01</date><risdate>2011</risdate><volume>26</volume><issue>5</issue><spage>1559</spage><epage>1563</epage><pages>1559-1563</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Despite improvements in safety seen over the last 20 years, percutaneous renal biopsy is still associated with haemorrhagic complications. Due to concerns over delayed bleeding, most nephrologists would advocate overnight observation. Recent evidence in both adult and paediatric populations suggest that in some groups, this is unnecessary. Since 1991, we have provided a day-case renal biopsy service performing 70 such procedures per year. In this study, we present a retrospective analysis of this practice.
A total of 192 patients over a consecutive 3-year period were analysed retrospectively. Patients were selected according to standardized criteria, and biopsy was performed using a modern technique (automated biopsy needles under ultrasound guidance). Complications were identified by examination of case notes and local hospital admission databases, and by telephone interview. Our pathology database was examined for sample adequacy and diagnosis.
There were no delayed complications in the study group with 187 patients (97.4%) being discharged home on the same day. Major complications occurred in five patients (2.6%), all related to bleeding. Of these, two needed radiological intervention to achieve haemostasis. Sufficient tissue for diagnosis was achieved in 97% of cases, with a mean of 47 ± 23 glomeruli obtained per patient. Most biopsies were obtained with ≤ 2 passes (84%).
Our findings show that in selected adult patients, renal biopsy can be performed as a day-case procedure. Given the benefits of day-case strategies in terms of patient and healthcare costs, we advocate increased utilization of this technique.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>20858764</pmid><doi>10.1093/ndt/gfq571</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Biopsy - adverse effects Biopsy - methods Case-Control Studies Emergency and intensive care: renal failure. Dialysis management Female Hospitalization Humans Intensive care medicine Kidney - pathology Male Medical sciences Middle Aged Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Postoperative Hemorrhage - etiology Postoperative Hemorrhage - prevention & control Prognosis Renal failure Retrospective Studies |
| title | Adult day-case renal biopsy: a single-centre experience |
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