Document Detail


Kidney biopsy in the critically ill patient, results of a multicentre retrospective case series.
MedLine Citation:
PMID:  23044736     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The impact of a contributive result of kidney biopsy on the management of patients in the intensive care unit (ICU) has not been extensively investigated. METHODS: Retrospective study conducted between 2000 and 2011 in five French ICUs. 56 patients who had at least one non renal organ failure, as defined by a Sequential Organ Failure Assessment (SOFA) score G3 on ICU admission, and in whom kidney biopsy was performed during ICU stay were included. Kidney samples were obtained by percutaneous (N=55) or transjugular biopsy (N=1). RESULTS: The mean Simplified Acute Physiology Score II and total SOFA scores on ICU admission were 52±19 years and 10.3±3.6, respectively. ICU mortality was 23%. The median [interquartile range] time between ICU admission and kidney biopsy was 9 days [5-21]. Pathologic findings in the 54 analyzable kidney biopsies were acute tubular necrosis (N=26), glomerulonephritis (N=14), acute vascular nephritis (N=11), acute interstitial nephritis (N=6), and deposit disease (N=3). Kidney biopsy was contributive to the management of 40 patients. In 23 of these, new treatments were started, in 13 ongoing treatments were stopped, including four lifesustaining therapies, and in 13 it was decided to start chronic renal replacement. Severe bleeding was observed in 7 patients, with fatal outcome in one case. CONCLUSIONS: Kidney biopsy may have a significant impact on the management of critically ill patients. Further studies should be done to identify the groups of ICU patients likely to benefit from the procedure with minimum risk.
Authors:
C Philipponnet; C Guérin; E Canet; R Robert; C Mariat; F Dijoud; E Azoulay; B Souweine; A E Heng
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-05
Journal Detail:
Title:  Minerva anestesiologica     Volume:  -     ISSN:  1827-1596     ISO Abbreviation:  Minerva Anestesiol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Service de Réanimation Médicale, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, F-63003, ClermontUniversité d'Auvergne, Clermont-Ferrand, France2 Service de Réanimation Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université de Lyon,Lyon, France3 Service de Réanimation Médicale, Hôpital Saint Louis, Paris F-75010, France4 Service de Réanimation, Hôpital Jean Bernard, CHU de Poitiers, Poitiers, France5 Service de Néphrologie, Hôpital Nord, CHU Saint Etienne, Saint Etienne, France6 Laboratoire d'Anatomie Pathologie, Centre de Pathologie-Est, Hospices Civils de Lyon, Université de Lyon,Lyon, France7 Service de Néphrologie, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, F-63003, Clermont-Ferrand,France - bsouweine@chu-clermontferrand.fr.
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