Bermejo Sheila, García-Carro Clara, Mast Richard, Vergara Ander, Agraz Irene, León Juan Carlos, Bolufer Monica, Gabaldon Maria-Alejandra, Serón Daniel, Bestard Oriol, Soler Maria Jose
Nephrology Department, Hospital de Vall d'Hebron, 08035 Barcelona, Spain.
Nephrology Department, Hospital Clínico San Carlos, 28940 Madrid, Spain.
J Clin Med. 2022 Mar 7;11(5):1459. doi: 10.3390/jcm11051459.
Kidney biopsy (KB) is the "gold standard" for the diagnosis of nephropathies and it is a diagnostic tool that presents a low rate of complications. Nowadays, biobank collections of renal tissue of patients with proven renal pathology are essential for research in nephrology. To provide enough tissue for the biobank collection, it is usually needed to obtain an extra kidney core at the time of kidney biopsy. The objective of our study is to evaluate the complications after KB and to analyze whether obtaining an extra core increases the risk of complications.
Prospective observational study of KBs performed at Vall d'Hebron Hospital between 2019 and 2020. All patients who accepted to participate to our research biobank of native kidney biopsies were included to the study. Clinical and laboratory data were reviewed and we studied risk factors associated with complications.
A total of 221 patients were included, mean age 56.6 (±16.8) years, 130 (58.8%) were men, creatinine was 2.24 (±1.94) mg/dL, proteinuria 1.56 (0.506-3.590) g/24 h, hemoglobin 12.03 (±2.3) g/dL, INR 0.99 (±0.1), and prothrombin time (PT) 11.86 (±1.2) s. A total of 38 patients (17.2%) presented complications associated with the procedure: 13.1% were minor complications, 11.3% ( = 25) required blood transfusion, 1.4% ( = 3) had severe hematomas, 2.3% ( = 5) required embolization, and 0.5% ( = 1) presented arterio-venous fistula. An increased risk for complication was independently associated with obtaining a single kidney core (vs. 2 and 3 cores) ( = 0.021).
KB is an invasive and safe procedure with a low percentage of complications. Obtaining an extra kidney core for research does not increase the risk of complications during the intervention, which remains low in concordance with previously published reports.
肾活检（KB）是肾病诊断的“金标准”，是一种并发症发生率较低的诊断工具。如今，对已确诊肾脏病理的患者的肾组织进行生物样本库收集，对肾脏病学研究至关重要。为给生物样本库收集提供足够的组织，通常需要在肾活检时获取额外的肾组织样本。本研究的目的是评估肾活检后的并发症，并分析获取额外样本是否会增加并发症风险。
对2019年至2020年在瓦尔德希伯伦医院进行的肾活检进行前瞻性观察研究。所有同意参与我们的天然肾活检研究生物样本库的患者均纳入研究。回顾临床和实验室数据，并研究与并发症相关的危险因素。
共纳入221例患者，平均年龄56.6（±16.8）岁，男性130例（58.8%），肌酐为2.24（±1.94）mg/dL，蛋白尿1.56（0.506 - 3.590）g/24 h，血红蛋白12.03（±2.3）g/dL，国际标准化比值（INR）0.99（±0.1），凝血酶原时间（PT）11.86（±1.2）s。共有38例患者（17.2%）出现与该操作相关的并发症：13.1%为轻微并发症，11.3%（n = 25）需要输血，1.4%（n = 3）有严重血肿，2.3%（n = 5）需要栓塞，0.5%（n = 1）出现动静脉瘘。获取单个肾组织样本（与获取2个和3个样本相比）独立增加了并发症风险（P = 0.021）。
肾活检是一种侵入性且安全的操作，并发症发生率较低。为研究获取额外的肾组织样本不会增加干预期间的并发症风险，与先前发表的报告一致，该风险仍然较低。
