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Renal biopsy: it is time for pragmatism and consensus

To obtain truly informed consent, we must be able to advise our patients accurately about the relative risk and benefit of any treatment plan. Percutaneous renal biopsy remains the gold standard investigation in the evaluation of intrinsic renal disease. There have been significant improvements in p...

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Detalles Bibliográficos
Autores principales: Lees, Jennifer S, McQuarrie, Emily P, Mackinnon, Bruce
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165764/
https://www.ncbi.nlm.nih.gov/pubmed/30289128
http://dx.doi.org/10.1093/ckj/sfy075
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author Lees, Jennifer S
McQuarrie, Emily P
Mackinnon, Bruce
author_facet Lees, Jennifer S
McQuarrie, Emily P
Mackinnon, Bruce
author_sort Lees, Jennifer S
collection PubMed
description To obtain truly informed consent, we must be able to advise our patients accurately about the relative risk and benefit of any treatment plan. Percutaneous renal biopsy remains the gold standard investigation in the evaluation of intrinsic renal disease. There have been significant improvements in practice over the past decades with regards to percutaneous renal biopsy. Across centres, we appear now to have reached agreement on many aspects of this procedure, such as the need for blood pressure control, avoidance of coagulopathy, use of spring-loaded needles under direct imaging guidance and a need to monitor for complications. The authors from Rush University Medical Centre provide reassurance that renal biopsy in the modern era remains a safe procedure with a low rate of significant bleeding. There remain areas of divergence in practice that may have unintended and deleterious consequences: administration of desmopressin and discontinuation of aspirin, for example, both carry a risk of thrombosis. It is our opinion that it is time to reach consensus on our interpretation of the available data and to draw up guidelines to standardize our biopsy practice internationally.
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spelling pubmed-61657642018-10-04 Renal biopsy: it is time for pragmatism and consensus Lees, Jennifer S McQuarrie, Emily P Mackinnon, Bruce Clin Kidney J Diagnostic Tests To obtain truly informed consent, we must be able to advise our patients accurately about the relative risk and benefit of any treatment plan. Percutaneous renal biopsy remains the gold standard investigation in the evaluation of intrinsic renal disease. There have been significant improvements in practice over the past decades with regards to percutaneous renal biopsy. Across centres, we appear now to have reached agreement on many aspects of this procedure, such as the need for blood pressure control, avoidance of coagulopathy, use of spring-loaded needles under direct imaging guidance and a need to monitor for complications. The authors from Rush University Medical Centre provide reassurance that renal biopsy in the modern era remains a safe procedure with a low rate of significant bleeding. There remain areas of divergence in practice that may have unintended and deleterious consequences: administration of desmopressin and discontinuation of aspirin, for example, both carry a risk of thrombosis. It is our opinion that it is time to reach consensus on our interpretation of the available data and to draw up guidelines to standardize our biopsy practice internationally. Oxford University Press 2018-10 2018-09-20 /pmc/articles/PMC6165764/ /pubmed/30289128 http://dx.doi.org/10.1093/ckj/sfy075 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Diagnostic Tests
Lees, Jennifer S
McQuarrie, Emily P
Mackinnon, Bruce
Renal biopsy: it is time for pragmatism and consensus
title Renal biopsy: it is time for pragmatism and consensus
title_full Renal biopsy: it is time for pragmatism and consensus
title_fullStr Renal biopsy: it is time for pragmatism and consensus
title_full_unstemmed Renal biopsy: it is time for pragmatism and consensus
title_short Renal biopsy: it is time for pragmatism and consensus
title_sort renal biopsy: it is time for pragmatism and consensus
topic Diagnostic Tests
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165764/
https://www.ncbi.nlm.nih.gov/pubmed/30289128
http://dx.doi.org/10.1093/ckj/sfy075
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