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Complications of percutaneous native kidney biopsies in adults in low and middle-income countries: A Systematic review and meta-analysis

Introduction: Kidney biopsy supports diagnoses, choice of treatment and prognostication in management of kidney diseases. Complications associated with this procedure varies among countries depending on several clinical and technical factors. This Systematic review and meta-analysis aims to report o...

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Main Author: Kajawo, Shepherd
Other Authors: Okpechi, Ikechi G
Format: Thesis
Language:English
Published: Department of Medicine 2021
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access_status_str Open Access
author Kajawo, Shepherd
author2 Okpechi, Ikechi G
author_browse Kajawo, Shepherd
Okpechi, Ikechi G
author_facet Okpechi, Ikechi G
Kajawo, Shepherd
author_sort Kajawo, Shepherd
collection Thesis
description Introduction: Kidney biopsy supports diagnoses, choice of treatment and prognostication in management of kidney diseases. Complications associated with this procedure varies among countries depending on several clinical and technical factors. This Systematic review and meta-analysis aims to report on these complications in low and middle-income countries (LMIC) and compare the burden of complications across different regions. Methods: Two independent reviewers searched studies from 1st January 1980 to 31st December 2017 in PubMed, Cochrane Reviews and African Journals Online. The study-specific estimates were pooled through a random-effects model meta-analysis to obtain an overall summary estimate of major complications across studies. Statistical heterogeneity was evaluated by the Cochrane's Q statistic. Results: 35 studies reporting on 18,456 kidney biopsies met the inclusion criteria. The overall rate of kidney biopsy complications was 14.0% (95% CI 10.0-18.0%).Major complications occurred in 1.3% (95% CI 0.8 – 2.4%) whilst minor complications were 10.9% (95% CI 0.07.4-14.9%). LMIC in Europe and Central Asia had the highest complications 21.4% (95% CI 19.1 – 23.8%) while East Asia and the Pacific had the least rates 7.9% (95% CI 1.8 – 17.7%); p< 0.001. Blind procedures had the highest overall complications, 21.2% (95% CI 17.6 – 25.0%), followed by pre-marking using ultrasound [13.9% (95% CI 7.8-21.3%) and least complications with real-time ultrasound (p=0.003). Death occurring post kidney biopsy was reported in 2 patients. Conclusion: Major complications associated with kidney biopsies in LMIC were low. However, minor complications still occur in significant proportions. Ultrasound-guided kidney biopsies and appropriate training will mitigate some of these risks.
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language eng
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2021
publishDateRange 2021
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spelling oai:open.uct.ac.za:11427/33824 Complications of percutaneous native kidney biopsies in adults in low and middle-income countries: A Systematic review and meta-analysis Kajawo, Shepherd Okpechi, Ikechi G Nephrology Introduction: Kidney biopsy supports diagnoses, choice of treatment and prognostication in management of kidney diseases. Complications associated with this procedure varies among countries depending on several clinical and technical factors. This Systematic review and meta-analysis aims to report on these complications in low and middle-income countries (LMIC) and compare the burden of complications across different regions. Methods: Two independent reviewers searched studies from 1st January 1980 to 31st December 2017 in PubMed, Cochrane Reviews and African Journals Online. The study-specific estimates were pooled through a random-effects model meta-analysis to obtain an overall summary estimate of major complications across studies. Statistical heterogeneity was evaluated by the Cochrane's Q statistic. Results: 35 studies reporting on 18,456 kidney biopsies met the inclusion criteria. The overall rate of kidney biopsy complications was 14.0% (95% CI 10.0-18.0%).Major complications occurred in 1.3% (95% CI 0.8 – 2.4%) whilst minor complications were 10.9% (95% CI 0.07.4-14.9%). LMIC in Europe and Central Asia had the highest complications 21.4% (95% CI 19.1 – 23.8%) while East Asia and the Pacific had the least rates 7.9% (95% CI 1.8 – 17.7%); p< 0.001. Blind procedures had the highest overall complications, 21.2% (95% CI 17.6 – 25.0%), followed by pre-marking using ultrasound [13.9% (95% CI 7.8-21.3%) and least complications with real-time ultrasound (p=0.003). Death occurring post kidney biopsy was reported in 2 patients. Conclusion: Major complications associated with kidney biopsies in LMIC were low. However, minor complications still occur in significant proportions. Ultrasound-guided kidney biopsies and appropriate training will mitigate some of these risks. 2021-08-24T01:59:52Z 2021-08-24T01:59:52Z 2021 2021-08-24T00:33:28Z Master Thesis Masters MPhil http://hdl.handle.net/11427/33824 eng application/pdf Department of Medicine Faculty of Health Sciences
spellingShingle Nephrology
Kajawo, Shepherd
Complications of percutaneous native kidney biopsies in adults in low and middle-income countries: A Systematic review and meta-analysis
thesis_degree_str Master's
title Complications of percutaneous native kidney biopsies in adults in low and middle-income countries: A Systematic review and meta-analysis
title_full Complications of percutaneous native kidney biopsies in adults in low and middle-income countries: A Systematic review and meta-analysis
title_fullStr Complications of percutaneous native kidney biopsies in adults in low and middle-income countries: A Systematic review and meta-analysis
title_full_unstemmed Complications of percutaneous native kidney biopsies in adults in low and middle-income countries: A Systematic review and meta-analysis
title_short Complications of percutaneous native kidney biopsies in adults in low and middle-income countries: A Systematic review and meta-analysis
title_sort complications of percutaneous native kidney biopsies in adults in low and middle income countries a systematic review and meta analysis
topic Nephrology
url http://hdl.handle.net/11427/33824
work_keys_str_mv AT kajawoshepherd complicationsofpercutaneousnativekidneybiopsiesinadultsinlowandmiddleincomecountriesasystematicreviewandmetaanalysis