Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment
Abstract Background Percutaneous renal biopsy (PRB) is an important technique providing relevant information to guide diagnosis and treatment in renal disease. As an invasive procedure it has complications. Most studies up to date have analysed complications related to bleeding. We report the larges...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-12-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12882-017-0786-0 |
| _version_ | 1831632349768450048 |
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| author | R. Haridian Sosa-Barrios Victor Burguera Nuria Rodriguez-Mendiola Cristina Galeano Sandra Elias Gloria Ruiz-Roso Sara Jimenez-Alvaro Fernando Liaño Maite Rivera-Gorrin |
| author_facet | R. Haridian Sosa-Barrios Victor Burguera Nuria Rodriguez-Mendiola Cristina Galeano Sandra Elias Gloria Ruiz-Roso Sara Jimenez-Alvaro Fernando Liaño Maite Rivera-Gorrin |
| author_sort | R. Haridian Sosa-Barrios |
| collection | DOAJ |
| description | Abstract Background Percutaneous renal biopsy (PRB) is an important technique providing relevant information to guide diagnosis and treatment in renal disease. As an invasive procedure it has complications. Most studies up to date have analysed complications related to bleeding. We report the largest single-center experience on routine Doppler ultrasound (US) assessment post PRB, showing incidence and natural history of arteriovenous fistulae (AVF) post PRB. Methods We retrospectively analysed 327 consecutive adult PRB performed at Ramon Cajal University Hospital between January 2011 and December 2014. All biopsies were done under real-time US guidance by a trained nephrologist. Routine Doppler mapping and kidney US was done within 24 h post biopsy regardless of symptoms. Comorbidities, full blood count, clotting, bleeding time and blood pressure were recorded at the time of biopsy. Post biopsy protocol included vitals and urine void checked visually for haematuria. Logistic regression was used to investigate links between AVF, needle size, correcting for potential confounding variables. Results 46,5% were kidney transplants and 53,5% were native biopsies. Diagnostic material was obtained in 90,5% (142 grafts and 154 native). Forty-seven AVF’s (14.37%) were identified with routine kidney Doppler mapping, 95% asymptomatic (n = 45), 28 in grafts (18.4%) and 17 natives (9.7%) (p-value 0.7). Both groups were comparable in terms of comorbidities, passes, cylinders or biopsy yield (p-value NS). 80% were <1 cm in size and 46.6% closed spontaneously in less than 30 days (range 3–151). Larger AVF’s (1–2 cm) took a mean of 52 days to closure (range 13–151). Needle size was not statistically significant factor for AVF (p-value 0.71). Conclusions Contrary to historical data published, AVF’s are a common complication post PRB that can be easily missed. Routine US Doppler mapping performed by trained staff is a cost-effective, non-invasive tool to diagnose and follow up AVF’s, helping to assess management. |
| first_indexed | 2024-12-19T05:17:20Z |
| format | Article |
| id | doaj.art-b489d736139546439e1c4a4b6882f815 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-19T05:17:20Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-b489d736139546439e1c4a4b6882f8152022-12-21T20:34:37ZengBMCBMC Nephrology1471-23692017-12-011811610.1186/s12882-017-0786-0Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessmentR. Haridian Sosa-Barrios0Victor Burguera1Nuria Rodriguez-Mendiola2Cristina Galeano3Sandra Elias4Gloria Ruiz-Roso5Sara Jimenez-Alvaro6Fernando Liaño7Maite Rivera-Gorrin8Nephrology Department. Ramon y Cajal University HospitalNephrology Department. Ramon y Cajal University HospitalNephrology Department. Ramon y Cajal University HospitalNephrology Department. Ramon y Cajal University HospitalNephrology Department. Ramon y Cajal University HospitalNephrology Department. Ramon y Cajal University HospitalNephrology Department. Ramon y Cajal University HospitalNephrology Department. Ramon y Cajal University HospitalNephrology Department. Ramon y Cajal University HospitalAbstract Background Percutaneous renal biopsy (PRB) is an important technique providing relevant information to guide diagnosis and treatment in renal disease. As an invasive procedure it has complications. Most studies up to date have analysed complications related to bleeding. We report the largest single-center experience on routine Doppler ultrasound (US) assessment post PRB, showing incidence and natural history of arteriovenous fistulae (AVF) post PRB. Methods We retrospectively analysed 327 consecutive adult PRB performed at Ramon Cajal University Hospital between January 2011 and December 2014. All biopsies were done under real-time US guidance by a trained nephrologist. Routine Doppler mapping and kidney US was done within 24 h post biopsy regardless of symptoms. Comorbidities, full blood count, clotting, bleeding time and blood pressure were recorded at the time of biopsy. Post biopsy protocol included vitals and urine void checked visually for haematuria. Logistic regression was used to investigate links between AVF, needle size, correcting for potential confounding variables. Results 46,5% were kidney transplants and 53,5% were native biopsies. Diagnostic material was obtained in 90,5% (142 grafts and 154 native). Forty-seven AVF’s (14.37%) were identified with routine kidney Doppler mapping, 95% asymptomatic (n = 45), 28 in grafts (18.4%) and 17 natives (9.7%) (p-value 0.7). Both groups were comparable in terms of comorbidities, passes, cylinders or biopsy yield (p-value NS). 80% were <1 cm in size and 46.6% closed spontaneously in less than 30 days (range 3–151). Larger AVF’s (1–2 cm) took a mean of 52 days to closure (range 13–151). Needle size was not statistically significant factor for AVF (p-value 0.71). Conclusions Contrary to historical data published, AVF’s are a common complication post PRB that can be easily missed. Routine US Doppler mapping performed by trained staff is a cost-effective, non-invasive tool to diagnose and follow up AVF’s, helping to assess management.http://link.springer.com/article/10.1186/s12882-017-0786-0Renal biopsyDiagnostic and interventional nephrologyRenal ultrasoundDoppler scanArteriovenous fistulaPost biopsy complication |
| spellingShingle | R. Haridian Sosa-Barrios Victor Burguera Nuria Rodriguez-Mendiola Cristina Galeano Sandra Elias Gloria Ruiz-Roso Sara Jimenez-Alvaro Fernando Liaño Maite Rivera-Gorrin Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment BMC Nephrology Renal biopsy Diagnostic and interventional nephrology Renal ultrasound Doppler scan Arteriovenous fistula Post biopsy complication |
| title | Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment |
| title_full | Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment |
| title_fullStr | Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment |
| title_full_unstemmed | Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment |
| title_short | Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment |
| title_sort | arteriovenous fistulae after renal biopsy diagnosis and outcomes using doppler ultrasound assessment |
| topic | Renal biopsy Diagnostic and interventional nephrology Renal ultrasound Doppler scan Arteriovenous fistula Post biopsy complication |
| url | http://link.springer.com/article/10.1186/s12882-017-0786-0 |
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