Abstract: FR-PO945
Safety Profile of Outpatient Percutaneous Native Renal Biopsy: A Large Monocentric Single Operator Cohort
Session Information
- Patient Safety
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Patient Safety
- 1501 Patient Safety
Authors
- Roccatello, Dario, Ospedale San GIovanni Bosco, Torino, Italy
- Sciascia, Savino, Center of Research of Immunopathology and Rare Diseases (CMID), Division of Clinical Immunology, Giovanni Bosco Hospital and University of Turin, Ita, Torino, Italy
- Fenoglio, Roberta, None, TORINO, Italy
Background
In the study we aim to evaluate the safety of performing percutaneous renal biopsy as an outpatient procedure compared to the traditional inpatient policy. Additionally, the rate and risk factors of complications after a procedure were investigated.
Methods
We ambispectively studied native kidney biopsies performed in our Institution between January 2000 and November 2015. Since January 2012, we began performing renal biopsies as outpatient procedures. Two groups of patients were considered: group I, in whom kidney biopsy was performed and followed by at least 1-day hospital admission; and group II, in whom renal biopsy was performed in the outpatient department and followed by 6 hours’ observation period and then by regular outpatient visits. All biopsies were performed by a single nephrologist with the use of real-time ultrasound and automated biopsy needle (18 gauge), following a structured protocol.
Results
462 biopsies were reviewed, 210 (45.5%) of patients were female and the mean age was 54.7 ± 17.9 years. One-hundred and twenty-nine (27.9%) of these biopsies were performed in outpatients. A total of 36 (7.8%) of patients developed a complication, and of those 9 (1.9%) suffered for a major complication [arteriovenous fistula (6 cases, 1.2%), ischaemic stroke (2, 0.4%), thromboembolic pulmonary embolism (1, 0,2%)] and 27 (5.8%) for minor [macroscopic haematuria (12 cases, 2,6% ), haematomas on sonography not requiring intervention (15 cases, 3,2%)]. When comparing the complication rate between group I and II, no statically difference were observed [overall 24 (7,2%) complications in group 1 and 12 (9,3%) in group II; 5 (1,5%) and 4 (3,1%) major, 19 (5,5%) and 8 (6.2%) minor complications, respectively in group I and II]. When analysing together both groups, after multivariate analysis, serum creatinine >3 mg/dl (OR 2.03 95%CI 1.18-6.81) and known severe hypertension (OR 2.01 95%CI 1.2-4.7) were found to be independent risk factors for minor and major complications, respectively. Conversely, we found no association of risk with the number of biopsy passes, gender, age, diagnosis, presence of haematuria before the kidney biopsy nor the degree of proteinuria.
Conclusion
Outpatient biopsy could be a valuable, safe, and perhaps cost-effective method of obtaining diagnostic renal tissue in the majority of patients.