Incidence of major complications after percutaneous native renal biopsies in adults from low-income to middle-income countries: a protocol for systematic review and meta-analysis

Abstract

IntroductionKidney biopsy is an essential tool for guiding clinicians towards diagnoses, treatment and determining prognosis in renal disease. However, the procedure can be marred by various complications. The reported occurrence of complications varies among countries or regions and is also affected by several clinical and technical factors. This systematic review and meta-analysis aims to evaluate the incidence of major complications after percutaneous native renal biopsy in low-income to middle-income countries (LMICs).Methods and analysisWe will include studies of populations from LMIC as per World Bank 2017 country list. Relevant abstracts published from 1 January 1980 to 30 December 2017 will be searched in PubMed, Cochrane, Excerpta Medica Database (Embase) and African Journals Online, without language restriction. Two reviewers will independently screen, select studies, extract data and assess the risk of bias in each study. A third reviewer will arbitrate in cases of disagreements. The study-specific estimates will be pooled through a random-effects model meta-analysis to obtain an overall summary estimate of the incidence of major complications across studies. Clinical and statistical heterogeneity will be evaluated by Cochrane’s Q statistic. Funnel-plot analysis and Egger’s test will be used to assess publication bias. Results will be presented by geographical region and income group.Ethics and disseminationThis study will use published data. Therefore, there is no requirement for ethical approval. This systematic review and meta-analysis is expected to inform healthcare workers and providers about the occurrence of major complications following renal biopsies and highlight possible actions needed to improve the safety of the procedure in LMICs. The final report will be published as an original article in a peer-reviewed journal. Findings will also be presented at a conference and submitted to relevant health authorities.PROSPERO registration numberCRD42017077656.

How does the presence of the pathologist affect the tissue adequacy and what are the factors affecting the pathologist in proficiency assessment, during percutaneous kidney biopsy?

“…Proteinuria, hematuria, renal involvement of systemic diseases, and unexplained renal failure are the most common biopsy indications 3 . Studies have reported that kidney biopsy may cause minor and major complications 4 . PCB has a low complication rate and is a safe, gold-standard method 5 .…”

Complications of Ultrasound Guided Renal Biopsy in 100 Children: Experience at a Tertiary Care Hospital

“…In 1962 the use of radiological images was introduced for the localization of the kidney, later replaced by the ultrasound real-time imaging 4 . In renal biopsy, use of automated device and ultrasound guidance improved the adequacy and reduced the complication 5 . Although minor consequences occur more frequently but major complication occur rarely.…”