REGULAR CONTENT
Final ID
520
Type
Original Scientific Research-Oral or Pos
Authors
Q Li1, A Samir1, X Zhang2, R Arellano1
Institutions
1Massachusetts General Hospital, Boston, MA, 2Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai
Purpose
To explore the relationship between core number and pathological adequacy in nonfocal renal biopsy, in order to help the on-site pathologist to balance safety and adequacy
Materials & Methods
Retrospectively reviewed the charts of ultrasound guided non-focal renal biopsies between 2006 and 2016 at a single institution, and collected the renal biopsy adequacy (number of glomeruli per biopsy: <10, 10-20, ≥20), the biopsy-related complications (major and minor), and the core number of each biopsy. The relationships among complications, core numbers, and adequacy of renal biopsy were analyzed.
Results
In the ten-year study interval, 542 adult patients with non-focal renal biopsies were identified. There were 11/542 (2.03%) major complications including perinephric hemorrhage that required angiographic embolization (n=8), renal arteriovenous fistulas (n=2), and blood transfusion (n=1). Minor complications occurred in 26/542 (4.80%) including retroperitoneal hematomas without intervention (n=22) and chart-recorded gross hematuria (n=4). All biopsies were performed using 14-g (n=4), 15-g (n=63), 16-g (n=248) or 18-g (n=174) cutting needles, and needle sizes were not found in 53 cases. The pathological biopsy yields were <10 in 108 cases (19.9%), 10-20 in 187 cases (34.5%), and ≥20 in 247 cases (45.6%). 2 cores and 3 cores or more were performed in 461 (85.1%) and 81 cases (14.9%), respectively. For the 11 cases with major complications, the biopsy glomeruli ranged 5-28 (median 15), and most of the major complications (9/11, 81.8%) occurred in the cases with lower yield (<20 glomeruli/biopsy). For all of the cases, the frequency of major complications in the low yield group (<20 glomeruli/biopsy, n=295) was significantly higher than that in high yield group (≥20 glomeruli/biopsy, n=247) (1.9% vs. 0.8%, p<0.05), but no difference was found on minor complications (6.1% vs. 4.0%, p=0.333). No association was found between the core number and the biopsy yield (p>0.05).
Conclusions
Our study demonstrated that the major complications of renal biopsy most probably occurred when the biopsy yield was low, and there may be no need to perform 3 or more cores when low glomeruli number was encountered.
Final ID
520
Type
Original Scientific Research-Oral or Pos
Authors
Q Li1, A Samir1, X Zhang2, R Arellano1
Institutions
1Massachusetts General Hospital, Boston, MA, 2Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai
Purpose
To explore the relationship between core number and pathological adequacy in nonfocal renal biopsy, in order to help the on-site pathologist to balance safety and adequacy
Materials & Methods
Retrospectively reviewed the charts of ultrasound guided non-focal renal biopsies between 2006 and 2016 at a single institution, and collected the renal biopsy adequacy (number of glomeruli per biopsy: <10, 10-20, ≥20), the biopsy-related complications (major and minor), and the core number of each biopsy. The relationships among complications, core numbers, and adequacy of renal biopsy were analyzed.
Results
In the ten-year study interval, 542 adult patients with non-focal renal biopsies were identified. There were 11/542 (2.03%) major complications including perinephric hemorrhage that required angiographic embolization (n=8), renal arteriovenous fistulas (n=2), and blood transfusion (n=1). Minor complications occurred in 26/542 (4.80%) including retroperitoneal hematomas without intervention (n=22) and chart-recorded gross hematuria (n=4). All biopsies were performed using 14-g (n=4), 15-g (n=63), 16-g (n=248) or 18-g (n=174) cutting needles, and needle sizes were not found in 53 cases. The pathological biopsy yields were <10 in 108 cases (19.9%), 10-20 in 187 cases (34.5%), and ≥20 in 247 cases (45.6%). 2 cores and 3 cores or more were performed in 461 (85.1%) and 81 cases (14.9%), respectively. For the 11 cases with major complications, the biopsy glomeruli ranged 5-28 (median 15), and most of the major complications (9/11, 81.8%) occurred in the cases with lower yield (<20 glomeruli/biopsy). For all of the cases, the frequency of major complications in the low yield group (<20 glomeruli/biopsy, n=295) was significantly higher than that in high yield group (≥20 glomeruli/biopsy, n=247) (1.9% vs. 0.8%, p<0.05), but no difference was found on minor complications (6.1% vs. 4.0%, p=0.333). No association was found between the core number and the biopsy yield (p>0.05).
Conclusions
Our study demonstrated that the major complications of renal biopsy most probably occurred when the biopsy yield was low, and there may be no need to perform 3 or more cores when low glomeruli number was encountered.