Evaluation of complications due to percutaneous renal biopsy in allografts and native kidneys with color-coded Doppler sonography.
We studied 142 consecutive percutaneous renal biopsies (puncturing on 73 allografts and 69 native kidneys) which were performed under continuous ultrasonic guidance, on 133 adult patients. The patients were monitored, at least, during the next 24 hours. We compared the complication rate for biopsies recording clinical and biochemical data and, the day after the biopsy, the kidney was examined with a color-coded Doppler sonography (CCDS): in real-time survey of the kidney and with spectral wave form analysis. The diagnosis of arteriovenous (AV) fistula was achieved detecting increased color saturation toward white, high peak systolic flow velocity and low resistive index in the supplying artery. Three procedures were excluded of the analyses because of incomplete data recorded, although none of them showed any remarkable complication. There was a 94.3% rate of successful biopsies. The mean +/- SEM number of glomeruli under light microscopic examination was 8.5 +/- 0.6. Complications occurred 64 times in relation to 55 patients with a higher incidence in allografts (61%) than in native kidneys (31%). Renal transplant patients showed higher serum creatinine values (5.8 +/- 0.8 vs. 3.2 +/- 0.4; p > 0.0001) and lower hematocrit (31.3 +/- 1.1 vs. 34.4 +/- 0.9; p = 0.025) than the native-kidney patients at the time of biopsy. De novo hematuria occurred in 30% of the procedures. In transplant patients, the gross hematuria incidence (9.9%) more than doubled that showed by native-kidney patients. The incidence of serious complications (hematoma, hemoperitoneum and AV fistula) was 16.5% and these were more frequent in transplant than in native kidneys.(ABSTRACT TRUNCATED AT 250 WORDS)
Gainza
F J
FJ
Department of Nephrology, Hospital de Cruces, Baracaldo/Vizcaya, Spain.
Minguela
I
I
Lopez-Vidaur
I
I
Ruiz
L M
LM
Lampreabe
I
I
D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000209:etiology*; D001707:Biopsy, Needle / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006417:Hematuria / Q000209:etiology; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000293:injuries*; D012082:Renal Veins / Q000293:injuries*; D018615:Ultrasonography, Doppler, Color