Utility of percutaneous renal biopsy in chronic kidney disease

Joseph, Anthony J.; Compton, Susan P.; Holmes, Lewis H; Annand, A.; Self, Sally; Fitzgibbon, Wayne R.; Ullian, Michael E.

doi:10.1111/j.1440-1797.2010.01293.x

Cited by 10 publications

(6 citation statements)

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“…Percutaneous kidney biopsy is currently the definitive diagnostic method for determining CKD etiology. Although the occurrence of complications is relatively low, the invasive nature of kidney biopsy has inherent risks which may rule out the use of the procedure with some patients such as those with compounding medical conditions [4]–[6]. Cost and access to care are also considerations for the use of renal biopsy [4].…”

Section: Introductionmentioning

confidence: 99%

Surface Glycosylation Profiles of Urine Extracellular Vesicles

et al. 2013

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Urinary extracellular vesicles (uEVs) are released by cells throughout the nephron and contain biomolecules from their cells of origin. Although uEV-associated proteins and RNA have been studied in detail, little information exists regarding uEV glycosylation characteristics. Surface glycosylation profiling by flow cytometry and lectin microarray was applied to uEVs enriched from urine of healthy adults by ultracentrifugation and centrifugal filtration. The carbohydrate specificity of lectin microarray profiles was confirmed by competitive sugar inhibition and carbohydrate-specific enzyme hydrolysis. Glycosylation profiles of uEVs and purified Tamm Horsfall protein were compared. In both flow cytometry and lectin microarray assays, uEVs demonstrated surface binding, at low to moderate intensities, of a broad range of lectins whether prepared by ultracentrifugation or centrifugal filtration. In general, ultracentrifugation-prepared uEVs demonstrated higher lectin binding intensities than centrifugal filtration-prepared uEVs consistent with lesser amounts of co-purified non-vesicular proteins. The surface glycosylation profiles of uEVs showed little inter-individual variation and were distinct from those of Tamm Horsfall protein, which bound a limited number of lectins. In a pilot study, lectin microarray was used to compare uEVs from individuals with autosomal dominant polycystic kidney disease to those of age-matched controls. The lectin microarray profiles of polycystic kidney disease and healthy uEVs showed differences in binding intensity of 6/43 lectins. Our results reveal a complex surface glycosylation profile of uEVs that is accessible to lectin-based analysis following multiple uEV enrichment techniques, is distinct from co-purified Tamm Horsfall protein and may demonstrate disease-specific modifications.

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Section: Introductionmentioning

confidence: 99%

Surface Glycosylation Profiles of Urine Extracellular Vesicles

et al. 2013

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Section: Chronic Kidney Diseasementioning

confidence: 99%

“…These subjects may have a higher risk of bleeding and have lower chances of diagnostic success, particularly when the kidneys are smaller and more scarred [94] . Nevertheless, renal biopsy in CKD patients is relatively a safe procedure as reported in several studies [94][95][96][97][98][99] and may represent a valid tool for clinical management. Renal tissue obtained by biopsy cannot give a great quantity of information if chronic damage (tubulointerstitial fibrosis, glomerulosclerosis, arteriosclerosis) prevails [8] and there is usually an inverse relationship between the degree of renal function and the need for therapeutic changes [94] .…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

“…Nevertheless, renal biopsy in CKD patients is relatively a safe procedure as reported in several studies [94][95][96][97][98][99] and may represent a valid tool for clinical management. Renal tissue obtained by biopsy cannot give a great quantity of information if chronic damage (tubulointerstitial fibrosis, glomerulosclerosis, arteriosclerosis) prevails [8] and there is usually an inverse relationship between the degree of renal function and the need for therapeutic changes [94] . Sparse evidence indicates that the histological diagnosis made in CKD patients can differ from the expected, clinically made diagnosis in a significant percentage of cases [95][96][97] .…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

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Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

Fiorentino

Bolignano²,

Tesař³

et al. 2016

Am J Nephrol

131

102

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Background: Although the number of patients reaching end-stage kidney disease without a biopsy-proven diagnosis is increasing, the utility of renal biopsy is still an object of debate. We analyzed epidemiological data and the main indications for renal biopsy with a systematic, evidence-based review at current literature. Summary: There is a high discrepancy observed in biopsy rates and in the epidemiology of glomerular diseases worldwide, related to the different time frame of the analyzed reports, lack of data collection, the different reference source population and the heterogeneity of indications. The evidence-based analysis of indications showed that renal biopsy should be crucial in adults with nephrotic syndrome or urinary abnormalities as coexistent hematuria and proteinuria and in corticosteroid resistant-children with severe proteinuria. The knowledge of renal histology can change the clinical management in patients with acute kidney injury significantly, after the exclusion of pre-renal or obstructive causes of kidney damage. Scarce evidence indicates that renal biopsy can be useful in patients with advanced chronic kidney disease and its use should always be considered after weighing the benefits and potential risks. Renal biopsy should be crucial in patients with renal involvement due to systemic disease. In patients with diabetes with atypical features, renal biopsy may be fundamental to diagnose an unexpected parenchymal disease mislabeled as diabetic nephropathy. Finally, in elderly patients, the indications and the risks are not different from those in the general population. Key Message: Renal biopsy still remains a concrete approach for managing a substantial percentage of renal diseases.

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“…Patient related factors include age >40 years, female gender, elevated serum creatinine and lower haemoglobin level at the time of the procedure. 5 , 9 , 10 The main procedure related factor was the use of 14G needles. It was observed that the increased number of passes due to the use of smaller diameter needles did not lead to increased haemorrhagic complications.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Determinants of Complications of Percutaneous Kidney Biopsy in a Large Cohort of Native Kidney and Kidney Transplant Recipients

Fatthy¹,

Saleh²,

Ahmed³

et al. 2021

Sultan Qaboos Univ Med J

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Objectives: Percutaneous kidney biopsy is a useful diagnostic procedure. Hemorrhagic complications may occur following the procedure. Methods: We retrospectively analyzed the records of 1198 patients who had percutaneous renal biopsy between March 2013 and March 2018. The cohort included both native kidney and transplant biopsies. We have included only the first biopsy for each patient; repeat biopsies for 132 patients were excluded from the analysis. Results: 1198 patients ( 332 transplant recipients and 886 native kidney patients) were included in the study. Major complications occurred in 18(1.5%) of patients (1.4% in native kidney biopsies Vs 1.6% in kidney transplant recipients. Adequate renal tissue (core of > 6 glomeruli ) was obtained in 91 % of patients. Our analysis revealed that the incidence of major complications, in the native kidney biopsy are increased with age>65 years (odds ratio2.4, 95 % CI (1.5-5.6), eGFR<30 ml/min/m2 (odds ratio 9.7, 95 % CI (3.4-18.2) ) and anemia(9-11 mg/dl)(odds ratio3.2 (1.7-5.2), 95 % CI(1.7-5.2). In transplant recipients kidney biopsy the incidence of complications was increased with age>65 years (odds ratio 2.8(1.7-7.3), 95 % CI (1.7-7.3), eGFR<30 ml/min/m2 (odds ratio 11.3, 95 % CI (3.5-16.8 ) and anemia (9-11mg/dl )(odds ratio 2.4, 95 %(1.7-4.7). Conclusion: The incidence of major complications following kidney biopsy was 1,5%(for a cohort of native kidney biopsy and kidney transplant biopsies . Age> 65 years, lower eGFR < <30 ml/min/m2 and anemia were independent risk predictors for the occurrence of major complications in both native and transplant kidney biopsy. Keywords: Biopsy; biopsy, needle; renal, complications, safety, adequacy.

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Utility of percutaneous renal biopsy in chronic kidney disease

Abstract: After more prolonged elevations of S-cr, PRB may be less safe and less likely to reveal treatable disease and opportunities for therapy.

Cited by 10 publications

References 10 publications

Surface Glycosylation Profiles of Urine Extracellular Vesicles

Surface Glycosylation Profiles of Urine Extracellular Vesicles

Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

Incidence and Determinants of Complications of Percutaneous Kidney Biopsy in a Large Cohort of Native Kidney and Kidney Transplant Recipients

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