The Native Kidney Biopsy

Hogan, Jonathan J.; Mocanu, Michaela; Berns, Jeffrey S.

doi:10.2215/cjn.05750515

Cited by 223 publications

(237 citation statements)

References 83 publications

(79 reference statements)

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“…Although renal biopsy remains the gold standard for diagnosis [6] , therapeutic management and outcome prediction in patients with renal parenchymal diseases, there is currently poor consensus about proper indications and clinical usefulness of this procedure [7] . As a result, the decision on performing renal biopsy is usually based on personal opinion and/or single-center policies.…”

Section: Introductionmentioning

confidence: 99%

Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

Fiorentino

Bolignano²,

Tesař³

et al. 2016

Am J Nephrol

120

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Background: Although the number of patients reaching end-stage kidney disease without a biopsy-proven diagnosis is increasing, the utility of renal biopsy is still an object of debate. We analyzed epidemiological data and the main indications for renal biopsy with a systematic, evidence-based review at current literature. Summary: There is a high discrepancy observed in biopsy rates and in the epidemiology of glomerular diseases worldwide, related to the different time frame of the analyzed reports, lack of data collection, the different reference source population and the heterogeneity of indications. The evidence-based analysis of indications showed that renal biopsy should be crucial in adults with nephrotic syndrome or urinary abnormalities as coexistent hematuria and proteinuria and in corticosteroid resistant-children with severe proteinuria. The knowledge of renal histology can change the clinical management in patients with acute kidney injury significantly, after the exclusion of pre-renal or obstructive causes of kidney damage. Scarce evidence indicates that renal biopsy can be useful in patients with advanced chronic kidney disease and its use should always be considered after weighing the benefits and potential risks. Renal biopsy should be crucial in patients with renal involvement due to systemic disease. In patients with diabetes with atypical features, renal biopsy may be fundamental to diagnose an unexpected parenchymal disease mislabeled as diabetic nephropathy. Finally, in elderly patients, the indications and the risks are not different from those in the general population. Key Message: Renal biopsy still remains a concrete approach for managing a substantial percentage of renal diseases.

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Section: Introductionmentioning

confidence: 99%

Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

Fiorentino

Bolignano²,

Tesař³

et al. 2016

Am J Nephrol

120

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“…We observed that 0.43% of the patients required blood transfusion and 1.0% of the patients experienced macroscopic hematuria. The bleeding rates of hematoma on CT ranged from 57% to 91% (versus 70% on ultrasound) in studies from the 1970s and 1980s, which used older scanners, biopsy techniques, and needles [1]. We observed perirenal hematoma in 85% of the cases on ultrasonography, including tiny 1×1 square millimeter hematomas; the findings depended on the evaluations of several operators.…”

Section: Discussionmentioning

confidence: 84%

“…We set a decrease in the Hb level as the primary outcome. There has been numerous previous reports on the predictors of bleeding complications; a review about the risk factors for bleeding complications was published in 2016 [1]. As reported previously, aging, female gender and renal dysfunction were associated with bleeding complications.…”

Section: Discussionmentioning

confidence: 86%

“…Since the 1950s, renal biopsy techniques have improved and the incidence of complications has been minimized [1]. Bleeding is the most frequent complication of percutaneous renal biopsy.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have revealed a number of predictors of bleeding complications. Multivariate analyses in prospective studies of kidney biopsies, have revealed that female gender, older age, hypertension, anemia, an elevated partial thromboplastin time (PTT), an elevated bleeding time (BT) and elevated serum creatinine levels are independent risk factors for bleeding complications [1-4]. Anatomic characteristics, such as small kidneys with thin cortices, cysts in the lower renal pole, or horseshoe kidney, may contraindicate a biopsy in some patients.…”

Section: Introductionmentioning

confidence: 99%

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Arterial Stiffness is an Independent Risk Factor for Anemia After Percutaneous Native Kidney Biopsy

Tanaka¹,

Kitagawa²,

Onishi

et al. 2017

Kidney Blood Press Res

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Background/Aims: Bleeding is the most common complication after renal biopsy. Although numerous predictors of bleeding have been reported, it remains unclear whether arterial stiffness affects bleeding complications. Method: We performed an observational study of the renal biopsies performed in our division over an approximately 6-year period (May 2010 to May 2016). The clinical and laboratory factors were analyzed to reveal the risk factors associated with bleeding, with a focus on anemia (defined as a ≥10% decrease in hemoglobin [Hb] after biopsy). The brachial-ankle pulse wave velocity (baPWV) was measured to evaluate arterial stiffness. Results: This study included 462 patients (male, n=244; female, n=218). Anemia (defined above) was observed in 54 patients (11.7%). The risk of anemia was higher in women, older patients, and patients with lower serum albumin, lower eGFR and lower diastolic blood pressure after biopsy. We then performed a further analysis of 187 patients whose baPWV data were available. Multivariate analysis revealed that a higher baPWV was an independent risk factor for anemia. ROC analysis for predicting anemia found that a baPWV value of 1839 cm/s had the best performance (AUC 0.689). Conclusion: An increased baPWV may be a more valuable predictor of bleeding than any of the other reported risk factors.

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Development and Validation of a Deep Learning Model to Quantify Interstitial Fibrosis and Tubular Atrophy From Kidney Ultrasonography Images

et al. 2021

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IMPORTANCE Interstitial fibrosis and tubular atrophy (IFTA) is a strong indicator of decline in kidney function and is measured using histopathological assessment of kidney biopsy core. At present, a noninvasive test to assess IFTA is not available. OBJECTIVE To develop and validate a deep learning (DL) algorithm to quantify IFTA from kidney ultrasonography images. DESIGN, SETTING, AND PARTICIPANTS This was a single-center diagnostic study of consecutive patients who underwent native kidney biopsy at John H. Stroger Jr. Hospital of Cook County,

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The Native Kidney Biopsy

Cited by 223 publications

References 83 publications

Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

Arterial Stiffness is an Independent Risk Factor for Anemia After Percutaneous Native Kidney Biopsy

Development and Validation of a Deep Learning Model to Quantify Interstitial Fibrosis and Tubular Atrophy From Kidney Ultrasonography Images

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