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Andrulli S, Rossini M, Gigliotti G, La Manna G, Feriozzi S, Aucella F, Granata A, Moggia E, Santoro D, Manenti L, Infante B, Ferrantelli A, Cianci R, Giordano M, Giannese D, Seminara G, Di Luca M, Bonomini M, Spatola L, Bruno F, Baraldi O, Micarelli D, Piemontese M, Distefano G, Mattozzi F, De Giovanni P, Penna D, Garozzo M, Vernaglione L, Abaterusso C, Zanchelli F, Brugnano R, Gintoli E, Sottini L, Quaglia M, Cavoli GL, De Fabritiis M, Conte MM, Manes M, Battaglia Y, Fontana F, Gesualdo L. The risks associated with percutaneous native kidney biopsies: a prospective study. Nephrol Dial Transplant 2022; 38:655-663. [PMID: 35587882 PMCID: PMC9976765 DOI: 10.1093/ndt/gfac177] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The known risks and benefits of native kidney biopsies are mainly based on the findings of retrospective studies. The aim of this multicentre prospective study was to evaluate the safety of percutaneous renal biopsies and quantify biopsy-related complication rates in Italy. METHODS The study examined the results of native kidney biopsies performed in 54 Italian nephrology centres between 2012 and 2020. The primary outcome was the rate of major complications 1 day after the procedure, or for longer if it was necessary to evaluate the evolution of a complication. Centre and patient risk predictors were analysed using multivariate logistic regression. RESULTS Analysis of 5304 biopsies of patients with a median age of 53.2 years revealed 400 major complication events in 273 patients (5.1%): the most frequent was a ≥2 g/dL decrease in haemoglobin levels (2.2%), followed by macrohaematuria (1.2%), blood transfusion (1.1%), gross haematoma (0.9%), artero-venous fistula (0.7%), invasive intervention (0.5%), pain (0.5%), symptomatic hypotension (0.3%), a rapid increase in serum creatinine levels (0.1%) and death (0.02%). The risk factors for major complications were higher plasma creatinine levels [odds ratio (OR) 1.12 for each mg/dL increase, 95% confidence interval (95% CI) 1.08-1.17], liver disease (OR 2.27, 95% CI 1.21-4.25) and a higher number of needle passes (OR for each pass 1.22, 95% CI 1.07-1.39), whereas higher proteinuria levels (OR for each g/day increase 0.95, 95% CI 0.92-0.99) were protective. CONCLUSIONS This is the first multicentre prospective study showing that percutaneous native kidney biopsies are associated with a 5% risk of a major post-biopsy complication. Predictors of increased risk include higher plasma creatinine levels, liver disease and a higher number of needle passes.
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Affiliation(s)
| | - Michele Rossini
- Nephrology, Dialysis and Transplantation, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Giuseppe Gigliotti
- Nephrology and Dialysis Unit, Maria Santissima Addolorata Hospital, Eboli, Italy
| | - Gaetano La Manna
- Nephrology Dialysis and Renal Transplantation Unit, University of Bologna, Bologna, Italy
| | - Sandro Feriozzi
- Nephrology and Dialysis Unit, Belcolle Hospital, Viterbo, Italy
| | - Filippo Aucella
- Nephrology and Dialysis Unit, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Antonio Granata
- Nephrology and Dialysis Unit, ‘San Giovanni di Dio’ Hospital, Agrigento, Italy
- Nephrology and Dialysis Unit, Cannizzaro Hospital, Catania, Italy
| | | | - Domenico Santoro
- Nephrology and Dialysis Unit, Università degli Studi di Messina Facoltà di Medicina e Chirurgia, Messina, Italy
| | - Lucio Manenti
- Dipartimento di Medicina e Chirurgia, UO di Nefrologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Barbara Infante
- Nephrology, Dialysis and Transplantation Unit, Department of Biomedical Sciences, University of Foggia, Foggia, Italy
| | - Angelo Ferrantelli
- Nephrology and Dialysis Unit, Villa Sofia Cervello United Hospitals, Palermo, Italy
| | - Rosario Cianci
- Nephrology Unit, Umberto I Policlinico di Roma, Roma, Italy
| | - Mario Giordano
- Nephrology Division, Giovanni XXIII Children's Hospital, Bari, Italy
| | - Domenico Giannese
- Nephrology, Dialysis, Transplantation, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | - Marina Di Luca
- Unit of Nephrology and Dialysis, San Salvatore Hospital, Pesaro, Italy
| | - Mario Bonomini
- Department of Medicine, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Leonardo Spatola
- Renal and Hemodialysis Unit, Istituto Clinico Humanitas, Rozzano, Italy
| | - Francesca Bruno
- Nephrology and Dialysis Unit, Maria Santissima Addolorata Hospital, Eboli, Italy
| | - Olga Baraldi
- Nephrology Dialysis and Renal Transplantation Unit, University of Bologna, Bologna, Italy
| | - David Micarelli
- Nephrology and Dialysis Unit, Belcolle Hospital, Viterbo, Italy
| | - Matteo Piemontese
- Nephrology and Dialysis Unit, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giulio Distefano
- Nephrology and Dialysis Unit, ‘San Giovanni di Dio’ Hospital, Agrigento, Italy
| | - Francesca Mattozzi
- Paediatric Nephrology Unit, Regina Margherita Children's Hospital, Torino, Italy
| | - Paola De Giovanni
- Nephrology and Dialysis Unit, Ospedale degli Infermi di Rimini, Rimini, Italy
| | - Davide Penna
- Nephrology and Dialysis Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Maurizio Garozzo
- Nephrology and Dialysis Unit, Santa Marta and Santa Venera Hospital District, Acireale, Italy
| | - Luigi Vernaglione
- Nephrology and Dialysis, ‘M. Giannuzzi’ Hospital of Manduria, Brindisi, Italy
| | - Cataldo Abaterusso
- Nephrology and Dialysis Unit, Civil Hospital of Castelfranco Veneto, Castelfranco Veneto, Italy
| | - Fulvia Zanchelli
- Nephrology and Dialysis Unit, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | | | - Enrica Gintoli
- Nephrology and Dialysis Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Laura Sottini
- Nephrology and Dialysis Unit, Presidio Ospedaliero Santa Chiara, Trento, Italy
| | - Marco Quaglia
- AOU Maggiore Della Carità, Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | | | - Marco De Fabritiis
- Nephrology and Dialysis Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Maria Maddalena Conte
- Nephrology and Dialysis Unit, University Hospital Maggiore della Carità, Novara, Italy
| | - Massimo Manes
- Nephrology and Dialysis Unit, Umberto Parini Hospital, Aosta, Italy
| | - Yuri Battaglia
- Nephrology and Dialysis Unit, Hospital-University St Anna, Ferrara, Italy
| | - Francesco Fontana
- Nephrology and Dialysis Unit, Azienda Ospedaliero Universitaria, Modena, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
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Donadio C, Kanaki A, Martin-Gomez A, Garcia S, Palacios-Gomez M, Donadio C, Calia D, Colombini E, DI Francesco F, Ghimenti S, Kanaki A, Onor M, Tognotti D, Fuoco R, Marka-Castro E, Torres Zamora MI, Giron-Mino J, Jaime-Solis MA, Arteaga LM, Romero H, Marka-Castro E, Akonur A, Leypoldt K, Asola M, Culleton B, Eloot S, Glorieux G, Nathalie N, Vanholder R, Perez de Jose A, Verdalles Guzman U, Abad Esttebanez S, Vega Martinez A, Barraca D, Yuste C, Bucalo L, Rincon A, Lopez-Gomez JM, Bataille P, Celine P, Raymond A, Francois G, Herve L, Michel D, Jean Louis R, Zhu F, Kotanko P, Thijssen S, Levin NW, Papamichail N, Bougiakli M, Gouva C, Antoniou S, Gianitsi S, Vlachopanou A, Chachalos S, Naka K, Kaarsavvidou D, Katopodis K, Michalis L, Sasaki K, Yasuda K, Yamato M, Surace A, Rovatti P, Steckiph D, Bandini R, Severi S, Dellacasa Bellingegni A, Santoro A, Arias M, Arias M, Sentis A, Perez N, Fontsere N, Vera M, Rodriguez N, Arcal C, Ortega N, Uriza F, Cases A, Maduell F, Abbas SR, Abbas SR, Zhu F, Kotanko P, Levin NW, Georgianos P, Sarafidis P, Nikolaidis P, Lasaridis A, Ahmed A, Ahmed A, Kaoutar H, Mohammed B, Zouhir O, Balter P, Ginsberg N, Taylor P, Sullivan T, Usvyat LA, Levin NW, Kotanko P, Zabetakis P, Moissl U, Ferrario M, Garzotto F, Wabel P, Cruz D, Tetta C, Signorini MG, Cerutti S, Brendolan A, Ronco C, Heaf J, Axelsen M, Pedersen RS, Ahmed A, Ahmed A, Amine H, Oualim Z, Ammirati AL, Guimaraes de Souza NK, Nemoto Matsui T, Luiz Vieira M, Alves de Oliveira WA, Fischer CH, Dias Carneiro F, Iizuka IJ, Aparecida de Souza M, Mallet AC, Cruz Andreoli MC, Cardoso Dos Santos BF, Rosales L, Dou Y, Carter M, Thijssen S, Kotanko P, Testa A, Sottini L, Giacon B, Prati E, Loschiavo C, Brognoli M, Marseglia C, Tommasi A, Sereni L, Palladino G, Bove S, Bosticardo G, Schillaci E, Detoma P, Bergia R, Park JW, Moon SJ, Choi HY, Ha SK, Park HC, Liao Y, Zhang L, Fu P, Igarashi H, Suzuki N, Esashi S, Masakane I, Panichi V, De Ferrari G, Saffiotti S, Sidoti A, Biagioli M, Bianchi S, Imperiali P, Gabrielli C, Conti P, Patrone P, Rombola G, Falqui V, Mura C, Icardi A, Rosati A, Santori F, Mannarino A, Bertucci A, Steckiph D, Jeong J, Jeong J, Kim OK, Kim NH, Bots M, Den Hoedt C, Grooteman MP, Van der Weerd NC, Mazairac AHA, Levesque R, Ter Wee PM, Nube MJ, Blankestijn P, Van den Dorpel MA, Park Y, Jeon J, Tessitore N, Tessitore N, Bedogna V, Girelli D, Corazza L, Jacky P, Guillaume Q, Julien B, Marcinkowski W, Drozdz M, Milkowski A, Rydzynska T, Prystacki T, August R, Benedyk-Lorens E, Bladek K, Cina J, Janiszewska G, Kaczmarek A, Lewinska T, Mendel M, Paszkot M, Trafidlo E, Trzciniecka-Kloczkowska M, Vasilevsky A, Konoplev G, Lopatenko O, Komashnya A, Visnevsky K, Gerasimchuk R, Neivelt I, Frorip A, Vostry M, Racek J, Rajdl D, Eiselt J, Malanova L, Pechter U, Selart A, Ots-Rosenberg M, Krieter DH, Seidel S, Merget K, Lemke HD, Wanner C, Krieter DH, Canaud B, Lemke HD, Rodriguez A, Morgenroth A, Von Appen K, Dragoun GP, Wanner C, Fluck R, Fouque D, Lockridge R, Motomiya Y, Uji Y, Hiramatsu T, Ando Y, Furuta M, Furuta M, Kuragano T, Kida A, Yahiro M, Otaki Y, Hasuike Y, Nonoguchi H, Nakanishi T, Sain M, Sain M, Kovacic V, Ljutic D, Radic J, Jelicic I, Yalin SF, Yalin SF, Trabulus S, Yalin AS, Altiparmak MR, Serdengecti K, Ohtsuka A, Fukami K, Ishikawa K, Ando R, Kaida Y, Adachi T, Sugi K, Okuda S, Nesterova OB, Nesterova OB, Suglobova ED, Golubev RV, Vasiliev AN, Lazeba VA, Smirnov AV, Arita K, Kihara E, Maeda K, Oda H, Doi S, Masaki T, Hidaka S, Ishioka K, Oka M, Moriya H, Ohtake T, Nomura S, Kobayashi S, Wagner S, Gmerek A, Wagner J, Wizemann V, Eftimovska - Otovic N, Spaseska-Gjurovska K, Bogdanovska S, Babalj - Banskolieva E, Milovanceva M, Grozdanovski R, Pisani A, Riccio E, Mancini A, Ambuhl P, Astrid S, Ivana P, Martin H, Thomas K, Hans-Rudolf R, Daniel A, Denes K, Marco M, Wuthrich RP, Andreas S, Andrulli S, Altieri P, Sau G, Bolasco P, Pedrini LA, Basile C, David S, Feriani M, Nebiolo PE, Ferrara R, Casu D, Logias F, Tarchini R, Cadinu F, Passaghe M, Fundoni G, Villa G, DI Iorio BR, Zoccali C, Locatelli F, Kihara E, Arita K, Hamamoto M, Maeda K, Oda H, Doi S, Masaki T, Lee DY, Kim B, Moon KH, LI Z, Fu P, Ahrenholz P, Ahrenholz P, Winkler RE, Waitz G, Wolf H, Grundstrom G, Alquist M, Holmquist M, Christensson A, Bjork P, Abdgawad M, Ekholm L, Segelmark M, Corsi C, Santoro A, De Bie J, Mambelli E, Mortara D, Santoro A, Severi S, Arroyo D, Arroyo D, Panizo N, Quiroga B, Reque J, Melero R, Rodriguez-Ferrero M, Rodriguez-Benitez P, Anaya F, Luno J, Ragon A, James A, Brunet P, Ribeiro S, Faria MS, Rocha S, Rodrigues S, Catarino C, Reis F, Nascimento H, Fernandes J, Miranda V, Quintanilha A, Belo L, Costa E, Santos-Silva A, Arund J, Tanner R, Fridolin I, Luman M, Clajus C, Clajus C, Kielstein JT, Haller H, David S, Basile C, Basile C, Libutti P, Lisi P, Vernaglione L, Casucci F, Losurdo N, Teutonico A, Lomonte C, Krisp C, Gmerek A, Wagner J, Wolters DA, Pedrini LA, Matsuyama M, Tomo T, Ishida K, Matsuyama K, Nakata T, Kadota J, Caiazzo M, Monari E, Cuoghi A, Bellei E, Bergamini S, Palladino G, Tomasi A, Baranger T, Seniuta P, Berge F, Drouillat V, Frangie C, Rosier E, Labonia W, Lescano A, Rubio D, Von der Lippe N, Jorgensen JA, Osthus TB, Waldum B, Os I, Bossola M, DI Stasio E, Antocicco M, Tazza L, Griveas I, Karameris A, Pasadakis P, Savica V, Santoro D, Saitta S, Tigano V, Bellinghieri G, Gangemi S, Daniela R, Checherita IA, Ciocalteu A, Vacaroiu IA, Niculae A, Bladek K, Stefaniak E, Pietrzak I, Krupa D, Garred L, Santoro A, Mancini E, Corrazza L, Atti M, Afsar B, Stamopoulos D, Mpakirtzi N, Gogola B, Zeibekis M, Stivarou D, Panagiotou M, Grapsa E, Vega Vega O, Barraca Nunez D, Abad Esttebanez S, Bucalo L, Yuste C, Lopez-Gomez JM, Fernandez-Lucas M, Gomis A, Teruel JL, Elias S, Quereda C, Hignell L, Humphrey S, Pacy N, Stamopoulos D, Mpakirtzi N, Afentakis N, Grapsa E. Extracorporeal dialysis: techniques and adequacy. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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