The incidence of major hemorrhagic complications after renal biopsies in patients with monoclonal gammopathies.
OBJECTIVE
Monoclonal gammopathies frequently cause renal disease, but they may be an incidental finding. Assessment of renal pathology in the context of renal dysfunction and a monoclonal gammopathy therefore serves as a useful diagnostic tool and, in addition, provides prognostic information. There is, however, a theoretical risk of increased hemorrhagic complications from renal biopsies in this setting. The purpose of this study was to determine the incidence of significant hemorrhagic complications after renal biopsies in patients with monoclonal gammopathies.


METHODS
The case notes of 1993 unselected patients from four teaching hospitals within the United Kingdom who underwent native or transplant renal biopsies between 1993 and 2008 were reviewed. Subjects were categorized as having a monoclonal gammopathy or not, and the incidence of major hemorrhagic complications between groups was compared.


RESULTS
In total, 74 (3.7%) patients (native and transplant biopsies) had a major hemorrhagic complication. One hundred forty-eight subjects with a monoclonal gammopathy were identified. The complication rate in this group was 4.1% compared with 3.9% in the control population (native biopsies only; P = 0.88).


CONCLUSIONS
In the population studied, the rate of major hemorrhagic complications after percutaneous renal biopsy was not significantly greater in patients with a monoclonal gammopathy.
Fish
Richard
R
Department of Renal Medicine, King's College Hospital, London, UK. rsfish@doctors.org.uk
Pinney
Jennifer
J
Jain
Poorva
P
Addison
Clara
C
Jones
Chris
C
Jayawardene
Satish
S
Booth
John
J
Howie
Alexander J
AJ
Ghonemy
Tareck
T
Rajabali
Shahista
S
Roberts
David
D
White
Lucy
L
Khan
Sofia
S
Morgan
Matthew
M
Cockwell
Paul
P
Hutchison
Colin A
CA
D000368:Aged; D001706:Biopsy / Q000009:adverse effects; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004739:England / Q000453:epidemiology; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors