Abstract: TH-PO1040
Feasibility and Safety of Percutaneous Kidney Biopsy in Small Kidneys: Breaking the Paradigm
Session Information
- CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Zepeda Quiroz, Ivan, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Estado de Mexico, Mexico
- Juarez Villa, Jose Daniel, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Estado de Mexico, Mexico
- Cortez, Brenda, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Estado de Mexico, Mexico
- Sanchez Vazquez, Omar Humberto, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
- Garcia Rivera, Alejandro, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
- Gomez Johnson, Victor Hugo, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Estado de Mexico, Mexico
- Moguel, Bernardo, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Estado de Mexico, Mexico
Background
Percutaneous kidney biopsy (PKB) is a vital diagnostic tool, there are absolute and relative contraindications. Kidney size considered a relative contraindication due to poor accessibility and risk of complications, therefore, there is no consensus regarding the best approach in this setting.
Methods
Retrospective cross sectional at the Interventional Nephrology Department of the Instituto Nacional de Cardiologia Ignacio Chavez. Patients older than 16 years old who had kidney length of ≤ 8 cm and underwent a PKB of native kidneys from July 2019 to December 2022 were included. Sampling was performed in real time guided by ultrasound. For the comparative analysis, the Chi-square or Fisher’s exact test were used for qualitative variables, and the T-student or Mann-Witney U test for quantitative variables, according to their distribution.
Results
25 patients were included, 19 women and 6 men. The mean age was 42.3 ± 18.04. The mean kidney length was 7.56 ±0.33 and the mean width was 4.2 cm. All patients received only one puncture, with an average of 12 glomeruli. The mean serum creatinine was 1.94 mg/dL . Minor complications occurred in 5 patients, perirenal hematoma 3 , hematuria in 1 , and hematoma plus hematuria in 1 patient. Histological examination showed FSGS in 36% of cases, lupus nephritis in 20%, other glomerular diseases in 16%, crescentic glomerulonephritis in 16%, and tubulointerstitial nephritis in 12%. Management was modified in 64% of cases. A bivariate analysis was performed for complications versus without complications based on clinical and ultrasound characteristics, where statistical significance was found for complications with pre-biopsy DBP of 89 ± 5.80 mmHg (p>0.001).
Conclusion
PKB in small kidneys is a feasible and safe procedure when properly planned, providing an adequate sample in all cases, with an insignificant number of minor complications, and that is clinically relevant.
Funding
- Government Support – Non-U.S.