Complications of Outpatient and Inpatient Renal Biopsy: A Systematic Review and Meta-Analysis.

Shih-Yi Lin,Cheng-Chieh Lin,Chia-Der Lin,Chia-Hung Kao,Cherry Yin-Yi Chang,I.-Wen Liu,Wu-Huei Hsu

doi:10.3390/diagnostics11040651

Shih-Yi Lin, Cheng-Chieh Lin + Show 5 more

Open Access

https://doi.org/10.3390/diagnostics11040651

Copy DOI

Abstract

Background: The evidence indicates that the optimal observation period following renal biopsy ranges between 6 and 8 h. This systematic review and meta-analysis explored whether differences exist in the complication rates of renal biopsies performed in outpatient and inpatient settings. Methods: We searched the MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 1985 to February 2020. Two reviewers independently selected studies evaluating the bleeding risk from renal biopsies performed in outpatient and inpatient settings and reviewed their full texts. The primary and secondary outcomes were risks of bleeding and major events (including mortality) following the procedure, respectively. Subgroup analysis was conducted according to the original study design (i.e., prospective or retrospective). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effect meta-analysis. Heterogeneity was assessed using the I2 test. Results: Data from all 10 eligible studies, which included a total of 1801 patients and 203 bleeding events, were included for analysis. Renal biopsies in outpatient settings were not associated with a higher bleeding risk than those in inpatient settings (OR = 0.81; 95% CI, 0.59–1.11; I2 = 0%). The risk of major events was also comparable across both groups (OR = 0.45; 95% CI, 0.16–1.29; I2 = 4%). Conclusions: Similar rates of bleeding and major events following renal biopsy in outpatient and inpatient settings were observed.

Highlights

Renal biopsy, a gold standard diagnostic tool in clinical nephrology, has been used for more than a century [1,2]
10 articles were included for analysis (Figure 1) [16,17,18,19,20,21,22,23,24,25]
One of the studies in which the procedures were conducted by radiologists [25], and the procedures of other studies were performed by nephrologists

Summary

Introduction

A gold standard diagnostic tool in clinical nephrology, has been used for more than a century [1,2]. Aside from its advantages, renal biopsy carries a risk of complications, the majority of which are bleeding (including insignificant perirenal hematoma, microhematuria, and macrohematuria). Their prevalence rate ranges between 0.8% and 5% [5,6]. This systematic review and meta-analysis explored whether differences exist in the complication rates of renal biopsies performed in outpatient and inpatient settings. Two reviewers independently selected studies evaluating the bleeding risk from renal biopsies performed in outpatient and inpatient settings and reviewed their full texts. Conclusions: Similar rates of bleeding and major events following renal biopsy in outpatient and inpatient settings were observed

Methods

Results

Conclusion