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. 2020 May;24(5):389-401.
doi: 10.1007/s10157-020-01869-w. Epub 2020 Mar 18.

A nationwide survey on clinical practice patterns and bleeding complications of percutaneous native kidney biopsy in Japan

Takehiko Kawaguchi  1 , Tasuku Nagasawsa  2 , Kazuhiko Tsuruya  3 , Kenichiro Miura  4 , Takayuki Katsuno  5 , Takashi Morikawa  6 , Eiji Ishikawa  7 , Masao Ogura  8 , Hideki Matsumura  9 , Ryota Kurayama  10 , Shinsuke Matsumoto  11 , Yuhji Marui  12 , Shigeo Hara  13 , Shoichi Maruyama  14 , Ichiei Narita  15 , Hirokazu Okada  16 , Yoshifumi Ubara  17 ; Committee of Practical Guide for Kidney Biopsy 2019
Affiliations

A nationwide survey on clinical practice patterns and bleeding complications of percutaneous native kidney biopsy in Japan

Takehiko Kawaguchi et al. Clin Exp Nephrol. 2020 May.

Erratum in

Abstract

Background: Practice patterns and bleeding complications of percutaneous native kidney biopsy (PNKB) have not recently been investigated and the Japanese Society of Nephrology performed a nationwide questionnaire survey in 2018.

Methods: The survey consisted of nine sections about PNKB: (1) general indications; (2) indications for high-risk patients; (3) informed consent; (4) pre-biopsy evaluation; (5) procedures; (6) sedation; (7) post-biopsy hemostasis, bed rest, and examinations; (8) bleeding complications; and (9) specimen processing. A supplementary survey examined bleeding requiring transcatheter arterial embolization (TAE).

Results: Overall, 220 directors of facilities (nephrology facility [NF], 168; pediatric nephrology facility [PF], 52) completed the survey. Indications, procedures, and monitoring protocols varied across facilities. Median lengths of hospital stay were 5 days in NFs and 6 days in PFs. Gauge 14, 16, 18 needles were used in 5%, 56%, 33% in NFs and 0%, 63%, 64% in PFs. Mean limits of needle passes were 5 in NFs and 4 in PFs. The bed rest period was 16-24 h in 60% of NFs and 65% of PFs. Based on 17,342 PNKBs, incidence rates of macroscopic hematuria, erythrocyte transfusion, and TAE were 3.1% (NF, 2.8%; PF, 6.2%), 0.7% (NF, 0.8%; PF, 0%), and 0.2% (NF, 0.2%; PF, 0.06%), respectively. Forty-six percent of facilities processed specimens all for light microscopy, immunofluorescence, and electron microscopy, and 21% processed for light microscopy only. Timing of bleeding requiring TAE varied among PNKB cases.

Conclusion: Wide variations in practice patterns of PNKB existed among facilities, while PNKBs were performed as safely as previously reported.

Keywords: Bleeding complication; Clinical practice pattern; Erythrocyte transfusion; Kidney biopsy; Macroscopic hematuria; Transcatheter arterial embolization.

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Conflict of interest statement

All the authors submitted conflict of interest statements based on academic society rules, which are managed by the Clinical and Experimental Nephrology (CEN). No authors have declared any competing interest.

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