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Published in: Journal of Nephrology 9/2023

04-09-2023 | Pre-Eclampsia | original Article

Diagnostic yield and safety of percutaneous native kidney biopsy in pregnancy: 20-years of single-center experience

Authors: Halil Yazici, Ahmet Burak Dirim, Nurana Garayeva, Seda Safak, Yasemin Ozluk, Ozge Hurdogan, Ozgur Akin Oto, Ayse Serra Artan, Aydin Turkmen

Published in: Journal of Nephrology | Issue 9/2023

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Abstract

Background

Percutaneous kidney biopsy is a fundamental procedure in nephrology. Although pregnancy is not a contraindication, a careful risk–benefit assessment is mandatory in pregnancy. We aimed to evaluate safety and diagnostic accuracy of percutaneous kidney biopsy in pregnancy in a single-center retrospective study.

Methods

Percutaneous kidney biopsy was performed in 19 pregnant patients. Demographics, estimated glomerular filtration rates, serum albumin levels, and proteinuria levels at the time of biopsy were evaluated. Biopsy-related complications, diagnoses, and treatments during the follow-up were analyzed. In addition, delivery success, preeclampsia, early delivery, low birth weight rates, and long-term outcomes of the patients were retrieved and analyzed.

Results

Mean patient age was 27 (range 16–41) years. Median gestational week at kidney biopsy was 20th. All but one biopsies were diagnostic. Median gestational week of delivery was 35 (range 23–39) gestational weeks. Preterm delivery (< 37 gestational weeks) and low birth weight (< 2500 mg) occurred in 73.7% and 52.6% of cases, respectively. Median weight at birth was 2500 mg. The incidence of preeclampsia was 57.9%. Overall 89.5% of the children survived. Median post-biopsy follow-up was 64 months. Maternal mortality was not observed during the follow-up period. End stage kidney disease developed in one patient. The results of percutaneous kidney biopsy led to therapeutic decisions in 73.7% of cases.

Conclusions

Although percutaneous kidney biopsy is not frequently performed during pregnancy, it is relatively safe and usually diagnostic, and may guide further follow-up.

Graphical abstract

Appendix
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Literature
1.
go back to reference Piccoli GB, Daidola G, Attini R, Parisi S, Fassio F, Naretto C et al (2013) Kidney biopsy in pregnancy: evidence for counselling? A systematic narrative review. BJOG 120:412–427CrossRefPubMed Piccoli GB, Daidola G, Attini R, Parisi S, Fassio F, Naretto C et al (2013) Kidney biopsy in pregnancy: evidence for counselling? A systematic narrative review. BJOG 120:412–427CrossRefPubMed
2.
go back to reference Leaños-Miranda A, Graciela Nolasco-Leaños A, Ismael Carrillo-Juárez R, José Molina-Pérez C, Janet Sillas-Pardo L, Manuel Jiménez-Trejo L et al (2020) Usefulness of the sFlt-1/PlGF (soluble fms-like tyrosine kinase-1/placental growth factor) ratio in diagnosis or misdiagnosis in women with clinical diagnosis of preeclampsia. Hypertension 76(3):892–900CrossRefPubMed Leaños-Miranda A, Graciela Nolasco-Leaños A, Ismael Carrillo-Juárez R, José Molina-Pérez C, Janet Sillas-Pardo L, Manuel Jiménez-Trejo L et al (2020) Usefulness of the sFlt-1/PlGF (soluble fms-like tyrosine kinase-1/placental growth factor) ratio in diagnosis or misdiagnosis in women with clinical diagnosis of preeclampsia. Hypertension 76(3):892–900CrossRefPubMed
3.
go back to reference Chen HH, Lin HC, Yeh JC, Chen CP (2001) Renal biopsy in pregnancies complicated by undetermined renal disease. Acta Obstet Gynecol Scand 80(10):888–893CrossRefPubMed Chen HH, Lin HC, Yeh JC, Chen CP (2001) Renal biopsy in pregnancies complicated by undetermined renal disease. Acta Obstet Gynecol Scand 80(10):888–893CrossRefPubMed
4.
go back to reference Kuller JA, D’Andrea NM, McMahon MJ (2001) Renal biopsy and pregnancy. Am J Obstet Gynecol 184(6):1093–1096CrossRefPubMed Kuller JA, D’Andrea NM, McMahon MJ (2001) Renal biopsy and pregnancy. Am J Obstet Gynecol 184(6):1093–1096CrossRefPubMed
5.
go back to reference Wide-Swensson D, Strevens H, Willner J (2007) Antepartum percutaneous renal biopsy. Int J Gynaecol Obstet 98:88–92CrossRefPubMed Wide-Swensson D, Strevens H, Willner J (2007) Antepartum percutaneous renal biopsy. Int J Gynaecol Obstet 98:88–92CrossRefPubMed
6.
go back to reference Day C, Hewins P, Hildebrand S, Sheikh L, Taylor G, Kilby M et al (2008) The role of renal biopsy in women with kidney disease identifed in pregnancy. Nephrol Dial Transplant 23:201–206CrossRefPubMed Day C, Hewins P, Hildebrand S, Sheikh L, Taylor G, Kilby M et al (2008) The role of renal biopsy in women with kidney disease identifed in pregnancy. Nephrol Dial Transplant 23:201–206CrossRefPubMed
7.
go back to reference De Castro I, Easterling TR, Bansal N, Jefferson JA (2017) Nephrotic syndrome in pregnancy poses risks with both maternal and fetal complications. Kidney Int 91(6):1464–1472CrossRefPubMed De Castro I, Easterling TR, Bansal N, Jefferson JA (2017) Nephrotic syndrome in pregnancy poses risks with both maternal and fetal complications. Kidney Int 91(6):1464–1472CrossRefPubMed
8.
go back to reference Webster P, Webster LM, Cook HT, Horsfield C, Seed PT, Vaz R, Lightstone L, Bramham K et al (2017) A multicenter cohort study of histologic findings and long-term outcomes of kidney disease in women who have been pregnant. Clin J Am Soc Nephrol 12(3):408–416CrossRefPubMed Webster P, Webster LM, Cook HT, Horsfield C, Seed PT, Vaz R, Lightstone L, Bramham K et al (2017) A multicenter cohort study of histologic findings and long-term outcomes of kidney disease in women who have been pregnant. Clin J Am Soc Nephrol 12(3):408–416CrossRefPubMed
10.
go back to reference Chen TK, Gelber AC, Witter FR, Petri M, Fine DM (2015) Renal biopsy in the management of lupus nephritis during pregnancy. Lupus 24(2):147–154CrossRefPubMed Chen TK, Gelber AC, Witter FR, Petri M, Fine DM (2015) Renal biopsy in the management of lupus nephritis during pregnancy. Lupus 24(2):147–154CrossRefPubMed
12.
go back to reference Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI et al (2009) CKD-EPI (chronic kidney disease epidemiology collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–12CrossRefPubMedPubMedCentral Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI et al (2009) CKD-EPI (chronic kidney disease epidemiology collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–12CrossRefPubMedPubMedCentral
14.
go back to reference Wiles K, Chappell L, Clark K, Elman L, Hall M, Lightstone L et al (2019) Clinical practice guideline on pregnancy and renal disease. BMC Nephrol 20(1):401CrossRefPubMedCentral Wiles K, Chappell L, Clark K, Elman L, Hall M, Lightstone L et al (2019) Clinical practice guideline on pregnancy and renal disease. BMC Nephrol 20(1):401CrossRefPubMedCentral
16.
Metadata
Title
Diagnostic yield and safety of percutaneous native kidney biopsy in pregnancy: 20-years of single-center experience
Authors
Halil Yazici
Ahmet Burak Dirim
Nurana Garayeva
Seda Safak
Yasemin Ozluk
Ozge Hurdogan
Ozgur Akin Oto
Ayse Serra Artan
Aydin Turkmen
Publication date
04-09-2023
Publisher
Springer International Publishing
Published in
Journal of Nephrology / Issue 9/2023
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI
https://doi.org/10.1007/s40620-023-01753-2

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