Year-end Sale % OFF 
Abstract
PurposeRenal biopsy-related arteriovenous fistula (RB-AVF), although usually asymptomatic, may sometimes result in serious clinical implications. The aim of the study was to prospectively evaluate the incidence of RB-AVF in native kidneys, together with the assessment of hemodynamic characteristics and the impact of the histopathological results of biopsy.Methods The study included 138 patients (age 46.2 ± 15.2; 70 F, 68 M), who underwent percutaneous renal biopsy (PRB) of the native kidney. In all patients, 2D and color Doppler ultrasound was performed 24 h after PRB in order to exclude RB-AVF.ResultsBleeding complications in the form of hematomas were found in 136 patients (98.55 %), and 23 cases of RB-AVF were observed (16.67 %). RB-AVF group had an increased maximal hematoma diameter and reduced number of glomeruli in PRB. The segmental arteries supplying the fistulas are characterized by higher maximum flow velocity (FV) and a lower resistance index (RI) compared to the normal segmental arteries (difference 45.9 ± 20.0 cm/s and 0.252 ± 0.104, respectively). In the ROC analysis, RI ≤ 0.524 allowed to detect RB-AVF with a sensitivity of 91 % and specificity of 100 % (AUC 0.998, p < 0.001). In approximately 39 % of RB-AVF cases, 2D ultrasound detected a hyperechogenic ischemic area between the fistula and the renal capsule.ConclusionsArteriovenous fistula is a quite frequent complication of native renal biopsy and can cause ischemia in the renal parenchyma detected by ultrasound. The arteries supplying the fistula are characterized by an increased flow velocity and reduced resistance index.
Highlights
Percutaneous renal biopsy (PRB) is an essential tool in the diagnosis of diseases of the native and transplanted kidneys
Arteriovenous fistula is a quite frequent complication of native renal biopsy and can cause ischemia in the renal parenchyma detected by ultrasound
The arteries supplying the fistula are characterized by an increased flow velocity and reduced resistance index
Summary
Percutaneous renal biopsy (PRB) is an essential tool in the diagnosis of diseases of the native and transplanted kidneys. Due to the technique and the ultrasound equipment necessary to monitor the procedure, in some centers, instead of nephrologists, PRB is more and more often performed by radiologists [3]. Clinical monitoring of a patient after PRB without radiological imaging as well as radiological approach without clinical data results in a significant discrepancy in the reported complications. A majority of observed fistulas are clinically asymptomatic and close spontaneously. This fact, together with ignoring the diagnostic ultrasound or discontinuation of the use of the color Doppler (CD) imaging in clinically silent cases, Int Urol Nephrol (2016) 48:1667–1673 contributes to reducing the incidence of RB-AVF. Some sources report significant clinical complications in as many as 20–41 % of RB-AVF cases and the necessity of invasive treatment [5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
