Safety and diagnostic yield of renal biopsy in the intensive care unit View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-07-10

AUTHORS

Jean-François Augusto, Vincent Lassalle, Pierre Fillatre, Dominique Perrotin, Ferhat Meziani, Maleka Schenck-Dhif, Pierre Edouard Bollaert, Damien du Cheyron, Gaetan Beduneau, Christophe Vinsonneau, Christophe Guitton, Nicolas Lerolle

ABSTRACT

PurposeRenal biopsy (RB) is occasionally performed in critically ill patients. The safety and impact of RB in this setting have not been reported.MethodsA 10-year (2000–2009) retrospective multicentre study was conducted in ten French intensive care units (ICU) on patients who underwent RB during their management. Medical files were retrieved for data analysis.ResultsSeventy-seven patients underwent an RB of which 68 (88 %) were on a native kidney and 9 (12 %) on a transplanted kidney. Percutaneous ultrasound-guided RB was used in most cases (87 %). Fifty-seven per cent of the patients were on mechanical ventilation at the time of RB. RB-related complications occurred in 17 (22 %) patients, two were graded as severe (requirement for kidney embolization, eventually successful). In 35 (51 %) non-transplanted patients, RB established a specific diagnosis other than acute tubular necrosis (ATN), which was diagnosed in only 18 % of patients. In the remaining patients, only non-specific lesions were observed. Therapeutic modifications followed RB in 14 (21 %) non-transplanted patients. Presence of signs of systemic disease involving the renal tract, occurrence of renal failure before hospital admission, and absence of any factor usually associated with ATN significantly predicted the presence of a specific diagnosis at RB other than ATN.ConclusionsIn this cohort, the contribution of RB to diagnosis and treatment was undeniable, but at the expense of frequent adverse events although most of them were not considered severe. More... »

PAGES

1826-1833

Journal

TITLE

Intensive Care Medicine

ISSUE

11

VOLUME

38

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-012-2634-9

DOI

http://dx.doi.org/10.1007/s00134-012-2634-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1016305929

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22777517


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27 schema:description PurposeRenal biopsy (RB) is occasionally performed in critically ill patients. The safety and impact of RB in this setting have not been reported.MethodsA 10-year (2000–2009) retrospective multicentre study was conducted in ten French intensive care units (ICU) on patients who underwent RB during their management. Medical files were retrieved for data analysis.ResultsSeventy-seven patients underwent an RB of which 68 (88 %) were on a native kidney and 9 (12 %) on a transplanted kidney. Percutaneous ultrasound-guided RB was used in most cases (87 %). Fifty-seven per cent of the patients were on mechanical ventilation at the time of RB. RB-related complications occurred in 17 (22 %) patients, two were graded as severe (requirement for kidney embolization, eventually successful). In 35 (51 %) non-transplanted patients, RB established a specific diagnosis other than acute tubular necrosis (ATN), which was diagnosed in only 18 % of patients. In the remaining patients, only non-specific lesions were observed. Therapeutic modifications followed RB in 14 (21 %) non-transplanted patients. Presence of signs of systemic disease involving the renal tract, occurrence of renal failure before hospital admission, and absence of any factor usually associated with ATN significantly predicted the presence of a specific diagnosis at RB other than ATN.ConclusionsIn this cohort, the contribution of RB to diagnosis and treatment was undeniable, but at the expense of frequent adverse events although most of them were not considered severe.
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35 French intensive care units
36 Percutaneous ultrasound-guided RB
37 PurposeRenal biopsy
38 Rb
39 ResultsSeventy-seven patients
40 absence
41 acute tubular necrosis
42 admission
43 adverse events
44 analysis
45 biopsy
46 care unit
47 cases
48 cent
49 cohort
50 complications
51 contribution
52 contribution of Rb
53 data analysis
54 diagnosis
55 diagnostic yield
56 disease
57 events
58 expense
59 factors
60 failure
61 files
62 frequent adverse events
63 hospital admission
64 ill patients
65 impact
66 impact of RB
67 intensive care unit
68 kidney
69 lesions
70 management
71 mechanical ventilation
72 medical files
73 modification
74 most cases
75 multicentre study
76 native kidneys
77 necrosis
78 non-specific lesions
79 non-transplanted patients
80 occurrence
81 patients
82 presence
83 presence of signs
84 renal biopsy
85 renal failure
86 renal tract
87 retrospective multicentre study
88 safety
89 setting
90 signs
91 specific diagnosis
92 study
93 systemic disease
94 therapeutic modification
95 time
96 time of RB
97 tract
98 treatment
99 tubular necrosis
100 ultrasound-guided RB
101 units
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