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Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment

BACKGROUND: Percutaneous renal biopsy (PRB) is an important technique providing relevant information to guide diagnosis and treatment in renal disease. As an invasive procedure it has complications. Most studies up to date have analysed complications related to bleeding. We report the largest single...

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Autores principales: Sosa-Barrios, R. Haridian, Burguera, Victor, Rodriguez-Mendiola, Nuria, Galeano, Cristina, Elias, Sandra, Ruiz-Roso, Gloria, Jimenez-Alvaro, Sara, Liaño, Fernando, Rivera-Gorrin, Maite
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738109/
https://www.ncbi.nlm.nih.gov/pubmed/29262805
http://dx.doi.org/10.1186/s12882-017-0786-0
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author Sosa-Barrios, R. Haridian
Burguera, Victor
Rodriguez-Mendiola, Nuria
Galeano, Cristina
Elias, Sandra
Ruiz-Roso, Gloria
Jimenez-Alvaro, Sara
Liaño, Fernando
Rivera-Gorrin, Maite
author_facet Sosa-Barrios, R. Haridian
Burguera, Victor
Rodriguez-Mendiola, Nuria
Galeano, Cristina
Elias, Sandra
Ruiz-Roso, Gloria
Jimenez-Alvaro, Sara
Liaño, Fernando
Rivera-Gorrin, Maite
author_sort Sosa-Barrios, R. Haridian
collection PubMed
description BACKGROUND: Percutaneous renal biopsy (PRB) is an important technique providing relevant information to guide diagnosis and treatment in renal disease. As an invasive procedure it has complications. Most studies up to date have analysed complications related to bleeding. We report the largest single-center experience on routine Doppler ultrasound (US) assessment post PRB, showing incidence and natural history of arteriovenous fistulae (AVF) post PRB. METHODS: We retrospectively analysed 327 consecutive adult PRB performed at Ramon Cajal University Hospital between January 2011 and December 2014. All biopsies were done under real-time US guidance by a trained nephrologist. Routine Doppler mapping and kidney US was done within 24 h post biopsy regardless of symptoms. Comorbidities, full blood count, clotting, bleeding time and blood pressure were recorded at the time of biopsy. Post biopsy protocol included vitals and urine void checked visually for haematuria. Logistic regression was used to investigate links between AVF, needle size, correcting for potential confounding variables. RESULTS: 46,5% were kidney transplants and 53,5% were native biopsies. Diagnostic material was obtained in 90,5% (142 grafts and 154 native). Forty-seven AVF’s (14.37%) were identified with routine kidney Doppler mapping, 95% asymptomatic (n = 45), 28 in grafts (18.4%) and 17 natives (9.7%) (p-value 0.7). Both groups were comparable in terms of comorbidities, passes, cylinders or biopsy yield (p-value NS). 80% were <1 cm in size and 46.6% closed spontaneously in less than 30 days (range 3–151). Larger AVF’s (1–2 cm) took a mean of 52 days to closure (range 13–151). Needle size was not statistically significant factor for AVF (p-value 0.71). CONCLUSIONS: Contrary to historical data published, AVF’s are a common complication post PRB that can be easily missed. Routine US Doppler mapping performed by trained staff is a cost-effective, non-invasive tool to diagnose and follow up AVF’s, helping to assess management.
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spelling pubmed-57381092017-12-21 Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment Sosa-Barrios, R. Haridian Burguera, Victor Rodriguez-Mendiola, Nuria Galeano, Cristina Elias, Sandra Ruiz-Roso, Gloria Jimenez-Alvaro, Sara Liaño, Fernando Rivera-Gorrin, Maite BMC Nephrol Research Article BACKGROUND: Percutaneous renal biopsy (PRB) is an important technique providing relevant information to guide diagnosis and treatment in renal disease. As an invasive procedure it has complications. Most studies up to date have analysed complications related to bleeding. We report the largest single-center experience on routine Doppler ultrasound (US) assessment post PRB, showing incidence and natural history of arteriovenous fistulae (AVF) post PRB. METHODS: We retrospectively analysed 327 consecutive adult PRB performed at Ramon Cajal University Hospital between January 2011 and December 2014. All biopsies were done under real-time US guidance by a trained nephrologist. Routine Doppler mapping and kidney US was done within 24 h post biopsy regardless of symptoms. Comorbidities, full blood count, clotting, bleeding time and blood pressure were recorded at the time of biopsy. Post biopsy protocol included vitals and urine void checked visually for haematuria. Logistic regression was used to investigate links between AVF, needle size, correcting for potential confounding variables. RESULTS: 46,5% were kidney transplants and 53,5% were native biopsies. Diagnostic material was obtained in 90,5% (142 grafts and 154 native). Forty-seven AVF’s (14.37%) were identified with routine kidney Doppler mapping, 95% asymptomatic (n = 45), 28 in grafts (18.4%) and 17 natives (9.7%) (p-value 0.7). Both groups were comparable in terms of comorbidities, passes, cylinders or biopsy yield (p-value NS). 80% were <1 cm in size and 46.6% closed spontaneously in less than 30 days (range 3–151). Larger AVF’s (1–2 cm) took a mean of 52 days to closure (range 13–151). Needle size was not statistically significant factor for AVF (p-value 0.71). CONCLUSIONS: Contrary to historical data published, AVF’s are a common complication post PRB that can be easily missed. Routine US Doppler mapping performed by trained staff is a cost-effective, non-invasive tool to diagnose and follow up AVF’s, helping to assess management. BioMed Central 2017-12-20 /pmc/articles/PMC5738109/ /pubmed/29262805 http://dx.doi.org/10.1186/s12882-017-0786-0 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Sosa-Barrios, R. Haridian
Burguera, Victor
Rodriguez-Mendiola, Nuria
Galeano, Cristina
Elias, Sandra
Ruiz-Roso, Gloria
Jimenez-Alvaro, Sara
Liaño, Fernando
Rivera-Gorrin, Maite
Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment
title Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment
title_full Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment
title_fullStr Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment
title_full_unstemmed Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment
title_short Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment
title_sort arteriovenous fistulae after renal biopsy: diagnosis and outcomes using doppler ultrasound assessment
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738109/
https://www.ncbi.nlm.nih.gov/pubmed/29262805
http://dx.doi.org/10.1186/s12882-017-0786-0
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