title: The incidence of major hemorrhagic complications after renal biopsies in patients with monoclonal gammopathies.
abstract: 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.
authors.affiliation: Department of Renal Medicine, King's College Hospital, London, UK. rsfish@doctors.org.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Fish
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pinney
authors.forename: Poorva
authors.initials: P
authors.lastname: Jain
authors.forename: Clara
authors.initials: C
authors.lastname: Addison
authors.forename: Chris
authors.initials: C
authors.lastname: Jones
authors.forename: Satish
authors.initials: S
authors.lastname: Jayawardene
authors.forename: John
authors.initials: J
authors.lastname: Booth
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Howie
authors.forename: Tareck
authors.initials: T
authors.lastname: Ghonemy
authors.forename: Shahista
authors.initials: S
authors.lastname: Rajabali
authors.forename: David
authors.initials: D
authors.lastname: Roberts
authors.forename: Lucy
authors.initials: L
authors.lastname: White
authors.forename: Sofia
authors.initials: S
authors.lastname: Khan
authors.forename: Matthew
authors.initials: M
authors.lastname: Morgan
authors.forename: Paul
authors.initials: P
authors.lastname: Cockwell
authors.forename: Colin A
authors.initials: CA
authors.lastname: Hutchison
mesh_terms: 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