Risk factors for bleeding complications in percutaneous renal biopsy

被引:183
作者
Eiro M. [1 ]
Katoh T. [1 ]
Watanabe T. [1 ]
机构
[1] Department of Internal Medicine III, Fukushima Medical University, Fukushima 960-1295
关键词
Bleeding tendency; Hematoma; Macrohematuria;
D O I
10.1007/s10157-004-0326-7
中图分类号
学科分类号
摘要
Background. Among the complications in percutaneous renal biopsy, bleeding is the most frequent and sometimes becomes fatal. Methods. We prospectively studied 394 consecutive percutaneous renal biopsies in 359 patients (male/female = 188/ 171). The mean age of the patients was 44.0 ±17.2 years. Percutaneous renal biopsies were performed on native kidneys under direct visualization by ultrasound, using an automated spring-loaded biopsy device and a 16-cm 18G needle. Results. The most common complication was hematoma (n = 149, 37.8%). "De novo macrohematuria" was observed in 29 patients (7.4%). Other complications included pain (n = 27, 6.9%), loss of blood (n = 17, 4.3%), and renal dysfunction (increase of serum creatinine more than 0.2 mg/ dl, n = 9, 2.2%). Although there were no severe complications such as loss of blood requiring a blood transfusion, loss of kidney function, or death, 10 patients had an extended rest period in bed because of moderate complications. Hypertension and amyloidosis had significant influence on the complications. Conclusions. For those who are clinically suspected of having amyloidosis or hypertension, more careful biopsy procedures and observations are necessary. © Japanese Society of Nephrology 2005.
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页码:40 / 45
页数:5
相关论文
共 17 条
[1]  
Fuiano G., Mazza G., Comi N., Caglioti A., De Nicola L., Iodice C., Andreucci M., Andreucci V.E., Current indications for renal biopsy: A questionnaire-based survey, Am J Kidney Dis, 35, pp. 448-457, (2000)
[2]  
Madaio M.P., Renal biopsy, Kidney Int, 38, pp. 529-543, (1990)
[3]  
Parrish A.E., Complications of percutaneous renal biopsy: A review of 37 years' experience, Clin Nephrol, 38, pp. 135-141, (1992)
[4]  
Wiseman D.A., Hawkins R., Numerow L.M., Taub K.J., Percutaneous renal biopsy utilizing real time, ultrasonic guidance and a semiautomated biopsy device, Kidney Int, 38, pp. 347-349, (1990)
[5]  
Burstein D.M., Korbet S.M., Schwartz M.M., The use of the automatic core biopsy system in percutaneous renal biopsies: A comparative study, Am J Kidney Dis, 22, pp. 545-552, (1993)
[6]  
Yoshinari M., Suzuki R., Watanabe K., Katoh T., Watanabe T., How long is enough: Length of renal needle biopsy specimen for histological diagnosis, Am J Nephrol, 22, (2002)
[7]  
Jackson G.G., Poirier K.P., Grieble H.G., Concept of pyelonephritis: Experience with renal biopsies and long-term clinical observations, Ann Intern Med, 47, pp. 1165-1183, (1957)
[8]  
Mostbeck G.H., Wittich G.R., Derfler K., Ulrich W., Walter R.M., Herold C., Haller J., Tscholakoff D., Optimal needle size for renal biopsy: In vivo evaluation, Radiology, 173, pp. 819-822, (1989)
[9]  
Song J.H., Cronan J.J., Percutaneous biopsy in diffuse renal disease: Comparison of 18- and 14-gauge automated biopsy devices, J Vase Int Radiol, 9, pp. 651-655, (1998)
[10]  
Hergesell O., Feiten H., Andrassy K., Kuhn K., Ritz E., Safety of ultrasound-guided percutaneous renal biopsy - Retrospective analysis of 1090 consecutive cases, Nephrol Dial Transplant, 13, pp. 975-977, (1998)