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Clin Exp Nephrol ; 24(5): 389-401, 2020 May.
Article in English | MEDLINE | ID: mdl-32189101

ABSTRACT

BACKGROUND: Practice patterns and bleeding complications of percutaneous native kidney biopsy (PNKB) have not recently been investigated and the Japanese Society of Nephrology performed a nationwide questionnaire survey in 2018. METHODS: The survey consisted of nine sections about PNKB: (1) general indications; (2) indications for high-risk patients; (3) informed consent; (4) pre-biopsy evaluation; (5) procedures; (6) sedation; (7) post-biopsy hemostasis, bed rest, and examinations; (8) bleeding complications; and (9) specimen processing. A supplementary survey examined bleeding requiring transcatheter arterial embolization (TAE). RESULTS: Overall, 220 directors of facilities (nephrology facility [NF], 168; pediatric nephrology facility [PF], 52) completed the survey. Indications, procedures, and monitoring protocols varied across facilities. Median lengths of hospital stay were 5 days in NFs and 6 days in PFs. Gauge 14, 16, 18 needles were used in 5%, 56%, 33% in NFs and 0%, 63%, 64% in PFs. Mean limits of needle passes were 5 in NFs and 4 in PFs. The bed rest period was 16-24 h in 60% of NFs and 65% of PFs. Based on 17,342 PNKBs, incidence rates of macroscopic hematuria, erythrocyte transfusion, and TAE were 3.1% (NF, 2.8%; PF, 6.2%), 0.7% (NF, 0.8%; PF, 0%), and 0.2% (NF, 0.2%; PF, 0.06%), respectively. Forty-six percent of facilities processed specimens all for light microscopy, immunofluorescence, and electron microscopy, and 21% processed for light microscopy only. Timing of bleeding requiring TAE varied among PNKB cases. CONCLUSION: Wide variations in practice patterns of PNKB existed among facilities, while PNKBs were performed as safely as previously reported.


Subject(s)
Biopsy/adverse effects , Embolization, Therapeutic/statistics & numerical data , Health Facilities/statistics & numerical data , Kidney/pathology , Postoperative Hemorrhage/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy/instrumentation , Biopsy/methods , Child , Child, Preschool , Erythrocyte Transfusion/statistics & numerical data , Female , Hematuria/etiology , Humans , Infant , Infant, Newborn , Informed Consent/statistics & numerical data , Japan , Length of Stay/statistics & numerical data , Male , Microscopy, Electron/statistics & numerical data , Middle Aged , Needles/statistics & numerical data , Nephrology/statistics & numerical data , Organizational Policy , Patient Selection , Pediatrics/statistics & numerical data , Postoperative Hemorrhage/etiology , Preoperative Care , Surveys and Questionnaires , Young Adult
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