Document Detail


Ultrasonography as a predictor of overt bleeding after renal biopsy.
MedLine Citation:
PMID:  19381759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Renal biopsy is essential for the diagnosis of kidney diseases, but complications, particularly bleeding incidents, remain problematic. METHODS: To evaluate the frequency of renal biopsy complications, and to reveal clinical and laboratory factors associated with overt bleeding complications, focusing on those available at hospital ward, we conducted a retrospective observational study for the period between 2001 and 2005 at Mie University Hospital in patients who underwent percutaneous renal biopsy of a native kidney. Of a total of 323 patients, 317 met the inclusion criteria. RESULTS: Only one patient (0.3%) required blood transfusion or intervention to stop bleeding. The mean decrease in hemoglobin (Hb) after biopsy was 0.43 +/- 0.7 g/dL. Hb decreased > or =1.0 g/dL in 66 patients (20.8%) and > or =10% in 32 patients (10.1%). On ultrasonography, perirenal hematoma was detected immediately after biopsy in 273 patients (86.1%), and 41 patients (12.9%) showed hematoma > or =2 cm in width. Analgesics were required for back pain in 67 patients (21.1%). Vasovagal response developed in 31 patients (9.8%). Macrohematuria occurred in 12 patients (3.8%). Urinary catheter was used in 161 patients (50.8%). For Hb decrease > or =10% after biopsy, multivariate analysis revealed perirenal hematoma (> or =2 cm) as a significant factor. Other significant factors were prolonged international normalized ratio of prothrombin time, elevated blood pressure on hospital admission, older age, increased serum creatinine level, and steroid use. CONCLUSION: Perirenal hematoma > or =2 cm on ultrasonography immediately after biopsy might well represent a predictive factor for bleeding complications.
Authors:
Eiji Ishikawa; Shinsuke Nomura; Tomiya Hamaguchi; Toshihide Obe; Michiyo Inoue-Kiyohara; Kazuki Oosugi; Kan Katayama; Masaaki Ito
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Publication Detail:
Type:  Journal Article     Date:  2009-04-21
Journal Detail:
Title:  Clinical and experimental nephrology     Volume:  13     ISSN:  1437-7799     ISO Abbreviation:  Clin. Exp. Nephrol.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-06     Completed Date:  2009-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9709923     Medline TA:  Clin Exp Nephrol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  325-31     Citation Subset:  IM    
Affiliation:
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edo-Bashi, Tsu, Mie 514-8507, Japan. ishijin@clin.medic.mie-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Analgesics / therapeutic use
Back Pain / drug therapy,  etiology
Biological Markers / blood
Biopsy, Needle / adverse effects*
Blood Transfusion
Female
Hematoma / etiology,  ultrasonography*
Hematuria / etiology
Hemoglobins / metabolism
Hemorrhage / etiology,  therapy,  ultrasonography*
Humans
Kidney / pathology*,  ultrasonography
Logistic Models
Male
Middle Aged
Odds Ratio
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Risk Factors
Syncope, Vasovagal / etiology
Young Adult
Chemical
Reg. No./Substance:
0/Analgesics; 0/Biological Markers; 0/Hemoglobins

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