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 Rb
37 ResultsSeventy-seven patients
38 absence
39 acute tubular necrosis
40 admission
41 adverse events
42 analysis
43 biopsy
44 care unit
45 cases
46 cent
47 cohort
48 complications
49 contribution
50 contribution of Rb
51 data analysis
52 diagnosis
53 diagnostic yield
54 disease
55 events
56 expense
57 factors
58 failure
59 files
60 frequent adverse events
61 hospital admission
62 ill patients
63 impact
64 intensive care unit
65 kidney
66 lesions
67 management
68 mechanical ventilation
69 medical files
70 modification
71 most cases
72 multicentre study
73 native kidneys
74 necrosis
75 non-specific lesions
76 non-transplanted patients
77 occurrence
78 patients
79 presence
80 presence of signs
81 renal biopsy
82 renal failure
83 renal tract
84 retrospective multicentre study
85 safety
86 setting
87 signs
88 specific diagnosis
89 study
90 systemic disease
91 therapeutic modification
92 time
93 tract
94 treatment
95 tubular necrosis
96 units
97 ventilation
98 yield
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