Purpose
To assess renal function and morphologic changes in patients who presented with bleeding after kidney biopsy who were treated with renal embolization as a definitive approach.
To demonstrate renal embolization is a safe and reliable technique which can be performed in cases of bleeding after renal biopsy, lowering the risk of needing an urgent nephrectomy.
To demonstrate renal embolization performed at early stages can preserve basal renal function.
Methods and materials
Background
Renal biopsy remains a gold standard procedure for the diagnosis of renal disease, which is performed in native and transplanted kidneys and is generally considered a safe procedure. (1)
The use of ultrasound guidance and automated biopsy gun provide a low risk of complications such as pain, bleeding, or a small hematoma. Major complications, including the need for nephrectomy or death, are extremely rare. (2)
Potential risk factors for bleeding complications are the female sex, elevated blood pressure, disturbed hemostasis and low hemoglobin level...
Results
All three patients showed favorable results and bleeding resolution after superselective embolization. None of them needed an urgent nephrectomy.
Patients were monitored one year after embolization. Renal gammagraphy, ultrasound test and a simple phase renal CT (computed tomography) were performed.
Two of them with no relevant morphologic changes at CT and US, with a renal function >90% seen at renal gammagraphy. (FIG. 9, 10, 11, 12)
The other patient showed a giant hematoma (which was not absorbed after the procedure), Causing compression and displacement of...
Conclusion
It was proved that a close follow-up after performing a renal biopsy helped the early diagnosis of complications, allowing an appropriate management (embolization), leading to preservation of renal function if treated at an early stage. (1)
The rate of complications after performing renal biopsy is very low, showing that only 3 (0.69%) patients required endovascular approach. (2)
It remains controversial but based on this study it is noted that young female patients with SLE diagnosis in which a native kidney biopsy is performed are more...
Personal information and conflict of interest
V. C. Avila; Guadalajara, JALISCO/MX - Author at Hospital Civil de Guadalajara M. A. Bohorquez; Guadalajara, JALISCO/MX - Author at Hospital Civil de Guadalajara R. Cerda de la Torre; Guadalajara, JALISCO/MX - Author at Hospital Civil de Guadalajara
The authorsdeclarethat there isno conflict of interestregarding the publication of this article.
References
Trajceska L., Severova G., Dzekova P. Complications and Risks of Percutaneous Renal Biopsy. Macedonian Journal of Medical Sciences. 2019 992-995
Roccatello D, Sciascia S, Rossi D, et al. Outpatient percutaneous native renal biopsy: safety profile in a large monocentric cohort. BMJ Open. 2017; 7:e015243.
Moledina G., Luciano R., Kukova L. Kidney Biopsy-Related Complications in Hospitalized Patients with Acute Kidney Disease. Clinical Journal of the American Society of Nephrology. 2018 1633-1640
Muller, A., Rouviere O., Renal Artery Embolization- indications, technical approaches and outcomes. Nature Reviews Neprhology...