Abstract

Dr. Sarfraz Ahmad, Dr. Umair Khan*, Dr. Rabia Shahid

ABSTRACT

Background: The indications for performing a renal biopsy vary among nephrologists, determined in part by the presenting signs and symptoms. Renal biopsy gives vital information which helps in estimating the disease prognosis, progression, and management. Percutaneous renal biopsies have good safety profile. Objective: To determine the outcomes and complications of renal biopsy done at Nephrology department of a tertiary care hospital. Study Design: A cross sectional, observational study. Place and Duration of Study: Nephrology department, Nishtar hospital Multan, from May 2017 to December 2017. Methodology: Patients were included in the study on the basis of non-probability consecutive sampling technique after taking informed consent. Prior to a percutaneous renal biopsy, a history, physical examination, Ultrasound and all baselines i.e. complete biochemical profile, complete blood count, renal parameters, complete urine analysis, viral markers, serology, platelet count, prothrombin time, partial thromboplastin time and bleeding time were done. All biopsies were conducted in the nephrology department under direct visualization of biopsy needle with ultrasonographic localization. . All the biopsies were obtained by percutaneous automated biopsy gun. Results: Total 56 patients were selected in the study. Among 56 patients 39 were male and 17 were female. Male to female ratio is 2.2/1. The age of patients ranges from 15 to 55 years with mean age of 29.4±12.1 years. Results of biopsy proven renal diseases were as, 16 (28.5%) were having Membranous Nephropathy, 12 (21.42%) were diagnosed Focal Segmental Glomerulosclerosis (FSGS), 8 (14.2%) diagnosed as Membranoproliferative GN (MPGN), 3 (5.3%) patients with IgA nephropathy, 9% were having amyloidosis. Biopsy results of two patient remained inconclusive. Patient remained under observation for 24 hours and also called for follow up to see the pattern of complication that he developed. Gross hematuria was observed in 5/56 patients, microscopic hematuria initially was present in all patient but after 12 hours only 30 patients were having microscopic hematuria on urine analysis, fall in Hb in 2 patients, Hypertension in 10 patients, tachycardia in 26 patients and urinary retention in 4 patients. Conclusion: We concluded that the most common pathology was membranous nephropathy followed by focal segmental glomerulosclerosis, Membranoproliferative GN and Amyloidosis. Percutaneous kidney biopsy can be safely conducted as an outpatient procedure with an observation time of 12 hours post-biopsy to watch for any complications.