Kidney biopsy in the critically ill patient, results of a multicentre retrospective case series.

Abstract : BACKGROUND: The impact of a contributive result of kidney biopsy on the management of patients in the intensive care unit (ICU) has not been extensively investigated yet. METHODS: This was a retrospective study conducted between 2000 and 2011 in five French ICUs. The study included 56 patients. They had at least one non-renal organ failure, as defined by a Sequential Organ Failure Assessment (SOFA) score ≥3 on ICU admission, and kidney biopsy was performed during ICU stay. Kidney samples were obtained by percutaneous (N.=55) or transjugular biopsy (N.=1). RESULTS: The mean Simplified Acute Physiology Score II and total SOFA scores on ICU admission were 52±19 years and 10.3±3.6, respectively. ICU mortality was 23%. The median (interquartile range) time between ICU admission and kidney biopsy was 9 days (5-21). Pathologic findings in the 54 analyzable kidney biopsies were acute tubular necrosis (N.=26), glomerulonephritis (N.=14), acute vascular nephritis (N.=11), acute interstitial nephritis (N.=6), and deposit disease (N.=3). Kidney biopsy was contributive to the management of 40 patients. In 23 of these, new treatments were started, in 13 ongoing treatments were stopped, including four life-sustaining therapies, and in 13 it was decided to start chronic renal replacement. Severe bleeding was observed in 7 patients, with fatal outcome in one case. CONCLUSION: Kidney biopsy may have a significant impact on the management of critically ill patients. Further studies should be done to identify the groups of ICU patients likely to benefit from the procedure with minimum risk.
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Submitted on : Wednesday, June 5, 2013 - 11:27:41 AM
Last modification on : Thursday, February 8, 2018 - 1:46:02 PM

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  • HAL Id : hal-00830518, version 1
  • PUBMED : 23044736

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C. Philipponnet, C. Guérin, E. Canet, R. Robert, C. Mariat, et al.. Kidney biopsy in the critically ill patient, results of a multicentre retrospective case series.. Minerva Anestesiologica, Edizione Minerva Medica, 2013, 79 (1), pp.53-61. ⟨hal-00830518⟩

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