Abstract

Dr. Ayesha Hanif*, Dr. Amna Razzaq and Dr. Amna Akbar

ABSTRACT

Background: Skepticism about performing renal biopsies is often because of uncertainty regarding risk of complications. The aim of this study was to evaluate safety and relevant complications of renal biopsies. Renal biopsy gives vital information which helps in estimating the disease prognosis, progression, and management. Percutaneous renal biopsy have good safety profile. Study Design: A cross sectional, observational study. Place and Duration of Study: Nephrology department, Bahawalpur Victoria hospital, from May 2017 to December 2017 Methodology: Patients were enclosed in the study on the idea of non-probability consecutive sampling technique after taking consent. Before a percutaneous kidney biopsy, a history, physical examination, Ultrasound and all baselines i.e. complete organic chemistry profile, complete blood count, renal parameters, complete urine analysis, viral markers, serology, platelet count, coagulation time, aPTT and bleeding time were done. All biopsies were conducted within the medical specialty department underneath direct visualization of biopsy needle with ultrasonographic localization. All the biopsies were obtained by percutaneous machine-controlled biopsy gun. Results: Total 116 patients were selected in the study. Among 116 patients 78 were male and 34 were female. Male to female ratio is 2:1. The age of patients ranges from 15 to 55 years with mean age of 25.4±11.2 years. Results of biopsy proven renal diseases were as, 32 (28.5%) were having Membranous Nephropathy, 24 (21.42%) were diagnosed Focal Segmental Glomerulosclerosis (FSGS), 16 (14.2%) diagnosed as Membranoproliferative GN (MPGN), 6 (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 10/116 patients, microscopic hematuria initially was present in all patient but after 12 hours only 60 patients were having microscopic hematuria on urine analysis, fall in Hb in 4 patients, Hypertension in 20 patients, tachycardia in 52 patients and urinary retention in 8 patients. Conclusion: We found that the most common histopathology 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.