Renal biopsy practice: What is the gold standard?

Table 1 Studies evaluating the safety of short observation time (< 24 h) after a percutaneous renal biopsy of native kidney

Study	Complications: minor/major	Timing of complications
Whittier et al[22] Retrospective 750 patients	6.6% minor complications 6.4% major complications (79% blood transfusion)	38 (42%) complications ≤ 4 h post RB 61 (67%) complications ≤ 8 h post RB 77 (85%) complications ≤ 12 h post RB 81 (89%) complications ≤ 24 h post RB
Lin et al[56] Retrospective 147 inpatients 183 outpatients	19.7% hematoma 6.4% macroscopic hematuria 0.9% pain No difference between in and out patients	2 outpatient admission (blood transfusion) all complications occurred within observation time of 6 h
Maya et al[57] Prospective N = 100	13% asymptomatic hematoma No major complications	All complications occured within 8 h of observation time 4% extended 24 h observation for decrease hematocrit
Margaryan et al[53] Retrospective, N = 146	Bleeding 2.8% Gross hematuria 1.4% Transfusion 0.69%, intervention 0	Hospital admission 5.6%, no late complications. Observation time 4-6 h
Jiang et al[52] Retrospective N = 475	6.9% minor complications 1.3% (6 patients) had major complications (transfusion or interventional radiology)	Median time for minor complications 2.5 h, 4/33 after 6 h 4/6 major complications occurred within 4 h, 1/6 at 12 h and 1/6 beyond 48 h
Carrington et al[50] Retrospective N = 192	3.6% (n = 7) immediate complications related to bleeding, 2/7 required blood transfusion and embolisation	All complications occurred within observation period of 8 h
McMahon et al[31] Prospective N = 105, low risk	11% required admission for complications (11/12 minor, 1 major complication)	9/12 during the observation time (5 h) 1 at 48 h (macroscopic hematuria), 2 at 5 d (AVF, hematoma)
Simard-Meilleur et al[13] Retrospective 164 inpatients 148 outpatients	15% symptomatic hematoma (pain, drop of more than 10 g/l Hb, gross hematuria, hypotension), 9% RBC transfusion, 1% angio-intervention	100% outpatient complications occurred during observation time (8 h)
Korbet et al[19] Prospective 1055 patients	Minor complications 8.1% Major complications 6.6%	57% of all complications occurred within 4 h, 72% within 8 h, 85% within 12 h and 89% within 24 h

RB: Renal biopsy.