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Kidney biopsy and complications

Masayoshi Okumi, Yasuyuki Sato, Kohei Unagami, Toshihito Hirai, Hideki Ishida, Kazunari Tanabe
BACKGROUND: The reasons for improved outcomes associated with preemptive kidney transplantation (PKT) are incompletely understood, and post-transplant complications have been scarcely investigated. METHODS: We evaluated the outcomes of PKT in both unmatched (n = 1060) and propensity score matched cohorts (n = 186) of adults who underwent living kidney transplant between 2000 and 2014. Outcomes were estimated glomerular filtration rate (eGFR), biopsy-proven rejection, cytomegalovirus (CMV) infection, post-transplant diabetes mellitus (PTDM), cardiovascular disease (CVD), graft failure (non-censored for death), and malignancy...
October 19, 2016: Clinical and Experimental Nephrology
Stephanie Preuss, Claudius Kuechle, Stefan Wagenpfeil, Christoph Schmaderer, Lutz Renders, Uwe Heemann, Konrad Stock
The aim of this retrospective single-center study was to examine ultrasound-detected complications after diagnostic parenchymal renal biopsies. After 471 ultrasound-guided kidney biopsies (225 native kidneys and 246 renal allografts), ultrasound revealed hematomas (21.9%), arterio-venous fistulas (8.9%), active bleeding (1.1%) and hematuria (0.4%). Only 0.8% of all patients required invasive intervention such as coiling (n = 3) and surgical procedures (n = 1). Three episodes of bleeding (0.6%) were solved with manual compression...
October 13, 2016: Ultrasound in Medicine & Biology
P García, M Huerfano, M Rodríguez, A Caicedo, F Berrío, C Gonzalez
BACKGROUND: Renal transplantation is the best treatment for end stage renal disease. Acute graft rejection is one of the main complications and may influence graft survival. OBJECTIVE: To determine the incidence and features of acute cellular rejection (ACR) episodes confirmed by biopsy. METHODS: We studied a cohort of 175 patients who underwent renal transplantation between 2004 and 2012 to determine the cumulative incidence of ACR confirmed by biopsy and to identify the associated risk factors using multivariate analysis...
2016: International Journal of Organ Transplantation Medicine
Roei Hod Feins, Anna Tobar, Miriam Davidovits
BACKGROUND: Kidney biopsy serves as an adjunct for the diagnosis of renal disease. However, it is not always productive. This study evaluated the yield and risks of kidney biopsies performed in 1995-2014 at a tertiary pediatric medical center. METHODS: The medical files of all patients who underwent closed percutaneous biopsy for various indications in native or transplanted kidneys were retrospectively reviewed for patient characteristics, technical and histopathologic findings, biopsy yield, and biopsy complications...
October 3, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Aoife Kilcoyne, Debra A Gervais
Percutaneous urologic biopsy is a safe and effective technique and can comprise a significant proportion of the daily workload of the interventional radiologist. This article discusses the indications and rationale for the performance of renal, ureter, and bladder biopsy as well as the approach to performing such biopsies, pitfalls, and potential complications.
September 2016: Techniques in Vascular and Interventional Radiology
Tingyang Hu, Qingquan Liu, Qin Xu, Hui Liu, Yan Feng, Wenhui Qiu, Fei Huang, Yongman Lv
This study aims to describe the unique characteristics of absorption fever in patients with a hematoma after percutaneous renal biopsy (PRB) and distinguish it from secondary infection of hematoma.We retrospectively studied 2639 percutaneous renal biopsies of native kidneys. We compared the clinical characteristics between 2 groups: complication group (gross hematuria and/or perirenal hematoma) and no complication group. The axillary temperature of patients with a hematoma who presented with fever was measured at 06:00, 10:00, 14:00, and 18:00...
September 2016: Medicine (Baltimore)
Genta Kanai, Takatoshi Kakuta, Takashi Hirukawa, Chizuko Okamatsu, Masafumi Fukagawa
We report a case of peritoneal mesothelioma discovered in a patient during peritoneal dialysis. The patient was a 55-year-old woman who had no history of asbestos exposure. Owing to end-stage kidney failure, she had been undergoing peritoneal dialysis for over 8 years, and she had been diagnosed with encapsulating peritoneal sclerosis. She was admitted to the hospital for intestinal obstruction. Three months later, she noticed an enlarging mass in the epigastric region. Computed tomography showed a 10-cm mass originating in the abdominal wall that had invaded the liver...
2016: Tokai Journal of Experimental and Clinical Medicine
Mittul Gulati, Suzanne L Palmer, Michael Y Im, Hossein Jadvar, Yasir A Qazi, Umer Fazli, Edward G Grant
PURPOSE: This study aims to determine a velocity threshold in the main renal vein (MRV) of renal transplants and evaluate the cause and clinical significance of elevated velocity. METHODS: Maximum MRV velocity from 331 consecutive renal transplant Doppler ultrasounds in 170 patients was recorded. A priori, twice the median MRV velocity was selected as the threshold for elevation. Ultrasounds were divided into "early" and "late" periods based on time after transplantation...
August 26, 2016: Clinical Imaging
Jose M Monroy Trujillo, Derek M Fine
Kidney abnormalities are present in up to 60% of patients with systemic lupus. Proliferative lupus nephritis is one of the most serious manifestation and requires rapid recognition and treatment. Kidney biopsy plays an essential role in the management and prognosis of proliferative lupus nephritis. Treatment includes and induction phase with systemic steroids and antiproliferative therapy. This is followed by a maintenance phase to prevent the risk of relapses. Cytotoxic therapy carries significant side effects and complications...
December 2016: Panminerva Medica
Gilda Diaz-Fuentes, Bharat Bajantri, Muhammad Adrish
BACKGROUND: Bronchoscopy with transbronchial and endobronchial biopsy and transbronchial needle aspiration is an important diagnostic tool in the pulmonologist's armamentarium. Safety in patients with pulmonary hypertension is controversial and many bronchoscopists consider this as a contraindication for the procedure. OBJECTIVES: To evaluate safety of bronchoscopy in patients with echocardiographic pulmonary hypertension and to compare with patients without it...
2016: Respiration; International Review of Thoracic Diseases
Arkadiusz Lubas, Anna Wojtecka, Jerzy Smoszna, Piotr Koziński, Emilia Frankowska, Stanisław Niemczyk
PURPOSE: Renal biopsy-related arteriovenous fistula (RB-AVF), although usually asymptomatic, may sometimes result in serious clinical implications. The aim of the study was to prospectively evaluate the incidence of RB-AVF in native kidneys, together with the assessment of hemodynamic characteristics and the impact of the histopathological results of biopsy. METHODS: The study included 138 patients (age 46.2 ± 15.2; 70 F, 68 M), who underwent percutaneous renal biopsy (PRB) of the native kidney...
October 2016: International Urology and Nephrology
Peter A Caputo, Homayoun Zargar, Daniel Ramirez, Hiury S Andrade, Oktay Akca, Tianming Gao, Jihad H Kaouk
BACKGROUND: The traditional treatment for a cT1b renal tumor has been radical nephrectomy. However, recent guidelines have shifted towards partial nephrectomy (PN) in selected patients with cT1b renal tumors. Furthermore, practitioners have extended the role of cryoablation (CA) to treat cT1b tumors in selected patients. OBJECTIVE: To evaluate the efficacy of CA compared to PN for cT1b renal tumors. DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective review of patients who underwent either renal CA (laparoscopic or percutaneous) or PN (robot-assisted) for a cT1b renal mass (>4cm and ≤7cm) between November 1999 and August 2014...
August 24, 2016: European Urology
M G Chen, X H Ye, H Y Liang, Q Yang
OBJECTIVE: To investigate the incidence, etiology, clinico- pathological characteristics and prognosis in primary IgA nephropathy (IgAN) children with acute kidney injury (AKI). METHOD: Retrospective analysis of the clinical and pathological manifestations and follow-up results of 19 Chlidren, who were associated with AKI in 196 cases of children with IgA nephropathy treated in our department from January, 1996 to Jun, 2012 was performed. RESULT: (1) The 19 cases associated with AKI accounted for 9...
August 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Liam Antony Lorentz, Linda Tebogo Hlabangana, Malcom Davies
BACKGROUND Percutaneous needle biopsy is routinely performed for renal allograft management. Vascular complications of the procedure include pseudoaneurysm and arterio-venous fistulae formation. Delayed diagnosis of these complications is due to their mostly asymptomatic and indolent nature. CASE REPORT We present a case of extensive intraparenchymal pseudoaneurysm formation within the inferior pole of the allograft, diagnosed two years following the most recent biopsy procedure. CONCLUSIONS Renal pseudoaneurysms may only be diagnosed years after their formation as they are typically asymptomatic...
2016: American Journal of Case Reports
Mauro Frongia, Rossano Cadoni, Andrea Solinas
BACKGROUND: Open surgery is the gold standard procedure for kidney transplantation. There is a strong rationale for using minimally invasive surgery in patients with end-stage renal disease. A robotic-assisted dual kidney transplant was performed for the first time at our institution. METHODS: In August 2013, a 63-year-old man with end-stage renal disease and diabetes mellitus under pharmacological control received both kidneys from a 70-year-old marginal donor...
October 2015: Transplantation Direct
G Basta-Jovanovic, Lj Bogdanovic, M Radunovic, M Prostran, R Naumovic, S Simic-Ogrizovic, S Radojevic-Skodric
Free radical-mediated injury releases proinflammatory cytokines and activates innate immunity. It has been suggested that the early innate response and the ischemic tissue damage play roles in the development of adaptive responses, which may lead to acute kidney rejection. Various durations of hypothermic kidney storage before transplantation add to ischemic tissue damage. The final stage of ischemic injury occurs during reperfusion that develops hours or days after the initial insult. Repair and regeneration processes occur together with cellular apoptosis, autophagy and necrosis and a favorable outcome is expected if regeneration prevails...
2016: Current Medicinal Chemistry
Samar Soliman, Chandra Mohan
Lupus nephritis (LN), a potentially destructive outcome of SLE, is a real challenge in the management of SLE because of the difficulty in diagnosing its subclinical onset and identifying relapses before serious complications set in. Conventional clinical parameters such as proteinuria, GFR, urine sediments, anti-dsDNA and complement levels are not sensitive or specific enough for detecting ongoing disease activity in lupus kidneys and early relapse of nephritis. There has long been a need for biomarkers of disease activity in LN...
August 3, 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
A Perkowska-Ptasińska, D Dęborska-Materkowska, M Serwańska-Świętek, M Wszoła, A Kwiatkowski, M Durlik
BACKGROUND: We report 2 cases of polyomavirus-associated nephropathy (PyVAN) emerging within the initial 8 posttransplant weeks. These cases were characterized by intraepithelial BK virus replication without typical nuclear inclusions in epithelial cells. METHODS AND RESULTS: A 70-year-old male recipient of a cadaveric kidney transplant had experienced unsatisfying graft function since the time of transplantation (Tx). One month after Tx, results of a graft biopsy revealed mild tubulointerstitial inflammation...
June 2016: Transplantation Proceedings
Agnieszka Wawrzecka, Anna Szymańska, Radosław Jeleniewicz, Marcin Szymański
Granulomatosis with polyangiitis is autoimmune and rare disease. It affects many organs, but the most often affected organs are the nose, lungs, and kidneys. It is part of vasculitis and causes an autoimmune attack by an abnormal type of circulating antibody termed ANCAs against small blood vessels. Disease concerns both men and women with a peak age of presentation in the sixth and seven decades. Typically upper and lower respiratory tract and kidneys are involved. Otitis externa, otitis media, or mastoiditis rarely occurs in granulomatosis with polyangiitis...
2016: Case Reports in Otolaryngology
Raimund H Pichler, Janna Huskey, Jolanta Kowalewska, Abdul Moiz, James Perkins, Connie L Davis, Nicolae Leca
BACKGROUND: Renal biopsy has been proposed to determine the cause or reversibility of renal failure for patients with end-stage liver disease and may be useful in the kidney allocation. Nevertheless, little data exist to validate the usefulness of kidney biopsies in this patient population. METHODS: We evaluated the utility of renal biopsies in a cohort of 59 consecutive liver transplant candidates with renal impairment of unclear etiology referred to determine the need for simultaneous liver kidney transplantation (SLK) versus liver alone transplantation (LAT)...
October 2016: Transplantation
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