Role of ultrasound in revealing complications following percutaneous renal biopsy in children

Hirano, Daishi; Fujinaga, Shuichiro; Nishizaki, Naoto; Kanai, Hiroaki; Ida, Hiroyuki

doi:10.5414/cn107926

Cited by 8 publications

(13 citation statements)

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“…One study by Shah et al (25) included fresh frozen plasma administration in addition to blood administration; all other studies reported only blood transfusion. Given that multiple studies included a blood transfusion event of zero (4,7,17,19,20,(22)(23)(24)26,27), a continuity correction of 0.5 was added to counts of zero to both event and nonevent rates for the purposes of this analysis. These 23 studies included 5504 total biopsies.…”

Section: Development Of Perinephric Hematoma Postbiopsymentioning

confidence: 99%

Bleeding Complications after Pediatric Kidney Biopsy

Varnell

Stone

Welge

2018

CJASN

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Background and objectives Kidney biopsy is an essential tool for the diagnosis and treatment of patients with kidney disease; however, because of its invasive nature, bleeding complications may arise. Design, setting, participants, & measurements We performed a meta-analysis of prospective or retrospective observational studies and randomized, controlled trials in pediatric patients undergoing native or transplant kidney biopsy in an inpatient or outpatient setting in MEDLINE-indexed studies from January 1998 to November 1, 2017 to determine the proportion of patients who develop hematoma, need blood transfusion, or need an additional intervention due to a complication after kidney biopsy. Results Twenty-three studies of 5504 biopsies met inclusion criteria. The proportion of patients developing hematoma after biopsy was between 11% (95% confidence interval, 7% to 17%) and 18% (95% confidence interval, 9% to 35%) using two analyses that included different time periods. The proportion needing blood transfusion was 0.9% (95% confidence interval, 0.5% to 1.4%). The proportion needing an additional intervention due to postbiopsy complication was 0.7% (95% confidence interval, 0.4% to 1.1%). Secondary analysis was not possible due to lack of data in the original manuscripts on laboratory values, needle gauges, number of needle passes, age of patient, or performer (attending versus trainee). Analysis with metaregression found that use of real-time ultrasound during biopsy did not modify the risk for hematoma, requirement of a blood products transfusion, or requirement of an additional procedure after biopsy. Analysis with metaregression comparing native biopsies with transplant biopsies did not reveal that biopsy type (native kidney biopsy versus transplant kidney biopsy) was associated with the need for a blood transfusion or requirement of an additional intervention after biopsy. Conclusions The development of perinephric hematoma after kidney biopsy is not an infrequent finding. The proportion of patients requiring blood transfusion or needing an additional intervention as a result of kidney biopsy in pediatric patients is significantly smaller.

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Section: Development Of Perinephric Hematoma Postbiopsymentioning

confidence: 99%

Bleeding Complications after Pediatric Kidney Biopsy

Varnell

Stone

Welge

2018

CJASN

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“…Several researches have proposed that post-biopsy ultrasound could be used to exclude the presence of complications [5,6]. One research has found that inpatient status and thrombocytopenia were the only significant risk factors for the complications [7].…”

Section: Introductionmentioning

confidence: 99%

Renal Parenchymal Thickness as a Predictor of Post Percutaneous Kidney Biopsy Complication

Zhang

Guo

et al. 2019

Urol Int

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Objective: To investigate the relationship of renal parenchymal thickness and the risk of developing post-procedure hematoma. Methods: Ultrasound-guided percutaneous renal biopsy was performed in 122 patients who underwent percutaneous kidney biopsy between January 2013 and December 2013 at Tai-he hospital. Post-biopsy renal ultrasound was performed within 12 h after the biopsy to assess the presence of hematoma in biopsied kidney. Logistic regression analysis was used to determine the effect of parenchymal thickness on formation of hematoma adjusted for other nonstructural patient-related factors such as age, sex, systolic and diastolic blood pressure, serum creatinine, and urea. Results: The incidence of complication was 19.4%, all of which were hematoma less than 5 cm. None of the patients went on to have severe complications that required clinical, surgical, or radiological intervention. Out of the collected clinical and anatomical parameters, renal parenchymal thickness of the biopsied kidney was found to be the only factor with strong association with complication risks. Conclusion: This is the first study investigating the impact of structural perimeters on complication risks of percutaneous renal biopsy. Renal parenchymal thickness is a significant predictor of presence of hematoma evident on post-biopsy ultrasound evaluation, which would be used in the early prevent the complications of percutaneous renal biopsy.

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“…Between April 2014 and January 2018, a total of 244 biopsies of native kidney were performed at Saitama Children's Medical Center. All biopsies, guided using real‐time ultrasonography, were performed by pediatric nephrologists with a 16 G automated spring‐loaded biopsy needle . Post‐biopsy ultrasonography showed peri‐renal hematoma in 99 patients (49 boys, 50 girls; median age, 9.0 years).…”

Section: Prb Subject Characteristics Vs Use Of Pslmentioning

confidence: 99%

“…All biopsies, guided using real-time ultrasonography, were performed by pediatric nephrologists with a 16 G automated spring-loaded biopsy needle. 2 Post-biopsy ultrasonography showed peri-renal hematoma in 99 patients (49 boys, 50 girls; median age, 9.0 years). Peri-renal hematomas were classified according to size, as previously reported: 3 small, ≤1/3 of maximum length of the biopsied kidney; and large, >1/3 of maximum length of the biopsied kidney.…”

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confidence: 98%

Inhibitory effect of steroid on absorption fever after percutaneous renal biopsy

Fujinaga

Sakuraya

2019

Pediatrics International

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Role of ultrasound in revealing complications following percutaneous renal biopsy in children

Abstract: Age ≥ 10 is an independent risk factor for post-PRB complication. After the procedure, the formation of a large hematoma predicted a complicated clinical course.

Cited by 8 publications

References 0 publications

Bleeding Complications after Pediatric Kidney Biopsy

Bleeding Complications after Pediatric Kidney Biopsy

Renal Parenchymal Thickness as a Predictor of Post Percutaneous Kidney Biopsy Complication

Inhibitory effect of steroid on absorption fever after percutaneous renal biopsy

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