Safety of outpatient kidney biopsies

BACKGROUND: Kidney biopsy is frequently performed in our centre as an outpatient procedure. The aim of this study was to evaluate the safety of biopsy in the outpatient setting. ----- METHODS: We analysed kidney biopsies performed from March 2013 to February 2017. Seven hundred twenty-five biopsies performed in the outpatient setting were identified: There were 592 transplant and 133 native biopsies including 3 solitary kidney biopsies. All were performed under ultrasound guidance using a 16G or 18G needle, with freehand technique. In all patients with estimated glomerular filtration rate (eGFR) 10%), without need for transfusion or intervention and macrohaematuria. ----- RESULTS: There were 506 (69.8%) male patients. Average age was 50.3 ± 12.7 years. Indications for native kidney biopsy included nephrotic syndrome (39.8%), nephritic syndrome (42.9%), follow-up biopsy (15.8%), and other (1.5%). There were no major complications. A decline in Hb was observed in 72% of patients. Average Hb decline was 4.2 ± 6.3 g/L. In 10.1% patients there was >10% reduction in Hb level, with no evident bleeding, including by ultrasonography. In 2.5% of patients, macrohaematuria was present. In a multivariate analysis, male gender, lower eGFR, higher pre-biopsy Hb and native kidney biopsy were predictive for Hb decline. No therapeutic interventions were required. ----- CONCLUSION: We found that kidney biopsy performed in an outpatient setting in select patients is only rarely associated with adverse events and is a safe procedure

Relationship between recipient and donor factors and kidney transplant outcome

Cilj: Iako je transplantacija bubrega najbolja metoda nadomještanja bubrežne funkcije, još uvijek postoji potreba za poboljšanjem dugoročnih ishoda. Cilj rada bio je utvrditi neovisnu povezanost demografskih čimbenika primatelja i darivatelja, osnovne bubrežne bolesti, trajanja liječenja dijalizom, tkivne nepodudarnosti i senzibilizacije s ishodima transplantacije u suvremenoj kohorti pacijenata kojima je presađen bubreg. Ispitanici i metode: U istraživanje su uključeni pacijenti kojima je transplantiran bubreg u Kliničkoj bolnici Merkur od lipnja 2007. do kraja 2018. god. Ishodi transplantacije praćeni su do 31. 12. 2019. godine. Najkraće vrijeme praćenja bila je jedna godina. Podaci su prikupljeni korištenjem izvješća iz aplikacije Eurotransplant Network Information System (ENIS; www.eurotransplant.org). Preživljenje je prikazano Kaplan-Meierovim krivuljama. Povezanost preživljenja s određenim obilježjima primatelja i darivatelja analizirana je univarijatnom i multivarijatnom Coxovom regresijom. Rezultati: U razdoblju od lipnja 2007. do konca 2018. presađeno je 480 bubrega u 472 pacijenta. 10-godišnje preživljenje pacijenata iznosilo je 72 %. Desetgodišnje preživljenje bubrega cenzurirano za smrt pacijenata s bubregom u funkciji bilo je 93 %. U multivarijatnoj analizi jedino dob primatelja pri transplantaciji, šećerna bolest kao uzrok osnovne bubrežne bolesti i trajanje liječenja dijalizom ostali su neovisno povezani s preživljenjem pacijenata. Zaključak: Transplantacija bubrega rezultira odličnim dugoročnim preživljenjem bubrega. Potrebno je poboljšati dugoročno preživljenje pacijenata, prevencijom, ranim otkrivanjem i intenzivnim liječenjem kroničnih bolesti.Aim: Although kidney transplantation is the best method of replacing renal function, there is still a need to improve long-term outcomes. The aim of this study was to determine the independent association of recipient and donor demographic factors, underlying renal disease, duration of dialysis treatment, tissue typing mismatch, and sensitization with transplant outcomes in a contemporary cohort of kidney transplant patients. Patients and methods: The study included patients who had a kidney transplantation at Clinical Hospital Merkur from June 2007 to the end of 2018. Transplant outcomes were monitored until December 31, 2019. The minimum follow-up time was 1 year. Data were collected using reports from the Eurotransplant Network Information System (ENIS) application (www.eurotransplant.org). Survival is shown by Kaplan-Meier curves. The association of survival with specific recipient and donor characteristics was analyzed by univariate and multivariate Cox regression. Results: In the period from June 2007 to the end of 2018, 480 kidneys were transplanted in 472 patients. The 10-year patient survival was 72%. Ten-year renal survival censored for the death of renal function patients was 93%. In the multivariate analysis, only recipient age at transplantation, diabetes as the cause of underlying renal disease and duration of dialysis remained independently associated with patient survival. Conclusion: Long-term graft survival is excellent after kidney transplantation. Long-term patient survival can be improved by prevention, early detection and intensive treatment of chronic diseases