PURPOSE: Renal biopsy (RB) is occasionally performed in critically ill patients. The safety and impact of RB in this setting have not been reported. METHODS: A 10-year (2000-2009) retrospective multicentre study was conducted in ten French intensive care units (ICU) on patients who underwent RB during their management. Medical files were retrieved for data analysis. RESULTS: Seventy-seven patients underwent an RB of which 68 (88 %) were on a native kidney and 9 (12 %) on a transplanted kidney. Percutaneous ultrasound-guided RB was used in most cases (87 %). Fifty-seven per cent of the patients were on mechanical ventilation at the time of RB. RB-related complications occurred in 17 (22 %) patients, two were graded as severe (requirement for kidney embolization, eventually successful). In 35 (51 %) non-transplanted patients, RB established a specific diagnosis other than acute tubular necrosis (ATN), which was diagnosed in only 18 % of patients. In the remaining patients, only non-specific lesions were observed. Therapeutic modifications followed RB in 14 (21 %) non-transplanted patients. Presence of signs of systemic disease involving the renal tract, occurrence of renal failure before hospital admission, and absence of any factor usually associated with ATN significantly predicted the presence of a specific diagnosis at RB other than ATN. CONCLUSIONS: In this cohort, the contribution of RB to diagnosis and treatment was undeniable, but at the expense of frequent adverse events although most of them were not considered severe.
PURPOSE: Renal biopsy (RB) is occasionally performed in critically illpatients. The safety and impact of RB in this setting have not been reported. METHODS: A 10-year (2000-2009) retrospective multicentre study was conducted in ten French intensive care units (ICU) on patients who underwent RB during their management. Medical files were retrieved for data analysis. RESULTS: Seventy-seven patients underwent an RB of which 68 (88 %) were on a native kidney and 9 (12 %) on a transplanted kidney. Percutaneous ultrasound-guided RB was used in most cases (87 %). Fifty-seven per cent of the patients were on mechanical ventilation at the time of RB. RB-related complications occurred in 17 (22 %) patients, two were graded as severe (requirement for kidney embolization, eventually successful). In 35 (51 %) non-transplanted patients, RB established a specific diagnosis other than acute tubular necrosis (ATN), which was diagnosed in only 18 % of patients. In the remaining patients, only non-specific lesions were observed. Therapeutic modifications followed RB in 14 (21 %) non-transplanted patients. Presence of signs of systemic disease involving the renal tract, occurrence of renal failure before hospital admission, and absence of any factor usually associated with ATN significantly predicted the presence of a specific diagnosis at RB other than ATN. CONCLUSIONS: In this cohort, the contribution of RB to diagnosis and treatment was undeniable, but at the expense of frequent adverse events although most of them were not considered severe.
Authors: Hervé Decousus; Victor F Tapson; Jean-François Bergmann; Beng H Chong; James B Froehlich; Ajay K Kakkar; Geno J Merli; Manuel Monreal; Mashio Nakamura; Ricardo Pavanello; Mario Pini; Franco Piovella; Frederick A Spencer; Alex C Spyropoulos; Alexander G G Turpie; Rainer B Zotz; Gordon Fitzgerald; Frederick A Anderson Journal: Chest Date: 2010-05-07 Impact factor: 9.410
Authors: Laurent Brochard; Fekri Abroug; Matthew Brenner; Alain F Broccard; Robert L Danner; Miquel Ferrer; Franco Laghi; Sheldon Magder; Laurent Papazian; Paolo Pelosi; Kees H Polderman Journal: Am J Respir Crit Care Med Date: 2010-05-15 Impact factor: 21.405
Authors: Ravindra L Mehta; John A Kellum; Sudhir V Shah; Bruce A Molitoris; Claudio Ronco; David G Warnock; Adeera Levin Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Michael Darmon; Marlies Ostermann; Jorge Cerda; Meletios A Dimopoulos; Lui Forni; Eric Hoste; Matthieu Legrand; Nicolas Lerolle; Eric Rondeau; Antoine Schneider; Bertrand Souweine; Miet Schetz Journal: Intensive Care Med Date: 2017-04-25 Impact factor: 17.440
Authors: Rinaldo Bellomo; Claudio Ronco; Ravindra L Mehta; Pierre Asfar; Julie Boisramé-Helms; Michael Darmon; Jean-Luc Diehl; Jacques Duranteau; Eric A J Hoste; Joannes-Boyau Olivier; Matthieu Legrand; Nicolas Lerolle; Manu L N G Malbrain; Johan Mårtensson; Heleen M Oudemans-van Straaten; Jean-Jacques Parienti; Didier Payen; Sophie Perinel; Esther Peters; Peter Pickkers; Eric Rondeau; Miet Schetz; Christophe Vinsonneau; Julia Wendon; Ling Zhang; Pierre-François Laterre Journal: Ann Intensive Care Date: 2017-05-04 Impact factor: 6.925