title: Percutaneous liver biopsy is safe in chronic hepatitis C patients with end-stage renal disease.
abstract: OBJECTIVE
  Liver biopsy is useful for staging fibrosis in chronic hepatitis C (CHC) patients with end-stage renal disease (ESRD) to determine renal transplant eligibility and to make CHC treatment decisions. There is concern about an increased risk associated with percutaneous liver biopsy (PCNB) in ESRD patients. We compared the safety of PCNB in CHC patients with and without ESRD.
  
  
  METHODS
  We reviewed PCNBs performed between 1996 and 2004 for technique, histology, and complications in 78 ESRD patients with CHC and in 241 control patients with CHC and no renal failure, randomly matched for age, sex, and race. Platelet counts, prothrombin, and partial thromboplastin times, but not bleeding times, were checked before biopsy. Deamino-8-D-arginine vasopressin was not given before the biopsy.
  
  
  RESULTS
  The mean age of the patients was 50 years; 72% were male, 97% were African American, and 3% were Caucasian. The control group had a significantly higher proportion of patients with advanced fibrosis (P < .04). Only 1 patient with ESRD (1.3%) developed a moderate complication. Five controls (2.1%) developed complications, 3 of which were severe.
  
  
  CONCLUSIONS
  Severe complications after PCNB are uncommon, and patients with ESRD and CHC are at no increased risk. Testing for bleeding time and the routine use of deamino-8-D-arginine vasopressin are not necessary before PCNB in patients with ESRD.
authors: Wayne State University School of Medicine, Detroit, Michigan, USA.
authors: Swati
authors: S
authors: Pawa
authors: Murray
authors: M
authors: Ehrinpreis
authors: Milton
authors: M
authors: Mutchnick
authors: James
authors: J
authors: Janisse
authors: Ravi
authors: R
authors: Dhar
authors: Firdous A
authors: FA
authors: Siddiqui
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D016022:Case-Control Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional