| How Long Should We Monitor the Patient for Bleeding after Percutaneous Renal Biopsy? |
| Jae-yoon Park, M.D., Sung-Woo Lee, M.D., Hajeong Lee, M.D., Hayne Park, M.D., Ho Seok Koo, M.D., Hyang Lim Lee, M.D., Hui Kyoung Sun, M.D., Dong Ki Kim, M.D., Yon Su Kim, M.D., Curie Ahn, M.D., Jin Suk Han, M.D., Suhnggwon Kim, M.D. and Kwon Wook Joo, M.D |
| Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea |
| 원저 : 경피적 신생검 후 적절한 관찰기간 |
| 박재윤, 이성우, 이하정, 박혜인, 구호석, 이향림, 선휘경, 김동기, 김연수, 안규리, 한진석, 김성권, 주권욱 |
| 서울대학교 의과대학 내과학교실 |
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| Abstract |
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Purpose: Percutaneous renal biopsy (PRB) may become complicated by serious bleeding. Overnight observation after renal biopsy is a standard safety strategy. Although it was recently reported that outpatient observation is safe, appropriate observation time after the renal biopsy is still in debate. We evaluated prospectively the incidence, onset time and risk factors of hemorrhagic complications to determine the optimal duration of observation after PRB.
Methods: We enrolled 100 patients who underwent renal biopsy from October 2009 to April 2010 using the standard strategy. The biopsy was performed by two experienced nephrologists using 16-gauge spring-loaded biopsy gun under real-time ultrasound guidance. Serial color Doppler ultrasound was done immediately, 8 hours, 24 hours and 1 week after the PRB.
Results: The 32 patients experienced hemorrhagic complications (32.0%, 10 with gross hematuria, 26 with hematoma, and 4 with both), and 1 major complication occurred 3 days after PRB. Baseline serum creatinine of the patient with the major complication was 6.0 mg/dL. Serum creatinine and BMI were higher in complication group (p<0.05). Number of needle passes, blood pressure, and degree of edema and proteinuria were not related to the complication. In multivariate analysis, serum creatinine was the only significant risk factor of complication (p=0.007). Hemorrhagic complications developed in 9 patients (28.1%) between 8 and 24 hours after PRB, all of which were minor.
Conclusion: The 8 hours’ observation time after renal biopsy may be deemed appropriate for stable patients with normal creatinine. |
| Key Words:
Biopsy, Complication, Ultrasound |
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