title: Adult day-case renal biopsy: a single-centre experience.
abstract: BACKGROUND
  Despite improvements in safety seen over the last 20 years, percutaneous renal biopsy is still associated with haemorrhagic complications. Due to concerns over delayed bleeding, most nephrologists would advocate overnight observation. Recent evidence in both adult and paediatric populations suggest that in some groups, this is unnecessary. Since 1991, we have provided a day-case renal biopsy service performing 70 such procedures per year. In this study, we present a retrospective analysis of this practice.
  
  
  METHODS
  A total of 192 patients over a consecutive 3-year period were analysed retrospectively. Patients were selected according to standardized criteria, and biopsy was performed using a modern technique (automated biopsy needles under ultrasound guidance). Complications were identified by examination of case notes and local hospital admission databases, and by telephone interview. Our pathology database was examined for sample adequacy and diagnosis.
  
  
  RESULTS
  There were no delayed complications in the study group with 187 patients (97.4%) being discharged home on the same day. Major complications occurred in five patients (2.6%), all related to bleeding. Of these, two needed radiological intervention to achieve haemostasis. Sufficient tissue for diagnosis was achieved in 97% of cases, with a mean of 47 ± 23 glomeruli obtained per patient. Most biopsies were obtained with ≤ 2 passes (84%).
  
  
  CONCLUSIONS
  Our findings show that in selected adult patients, renal biopsy can be performed as a day-case procedure. Given the benefits of day-case strategies in terms of patient and healthcare costs, we advocate increased utilization of this technique.
authors.affiliation: University Hospital of Wales, Heath Park, Cardiff CF14 4XW UK. christophercarrington@hotmail.com
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Carrington
authors.forename: Aled
authors.initials: A
authors.lastname: Williams
authors.forename: David F
authors.initials: DF
authors.lastname: Griffiths
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Riley
authors.forename: Kieron L
authors.initials: KL
authors.lastname: Donovan
mesh_terms: D000328:Adult; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011379:Prognosis; D012189:Retrospective Studies