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Direct Drug Delivery to Kidney via the Renal Artery
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Manual compression and reflex syncope in native renal biopsy.

Yoichi Takeuchi1, Yoshie Ojima2, Saeko Kagaya2

  • 1Division of Nephrology, Department of Medicine, Japanese Red Cross Ishinomaki Hospital, Nishimichishita-71 Hebita, Ishinomaki, Miyagi, 986-8522, Japan. muu_tko@yahoo.co.jp.

Clinical and Experimental Nephrology
|March 16, 2018
PubMed
Summary

Manual compression after percutaneous renal biopsy (PRB) increases the risk of transient hypotension, a minor complication. This finding suggests reconsidering routine compression protocols to improve patient quality of life post-procedure.

Keywords:
ComplicationsLogistic regression modelPercutaneous renal biopsyQuality of lifeStandard practice

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Area of Science:

  • Nephrology
  • Interventional Radiology
  • Patient Safety

Background:

  • Minimizing complications from diagnostic native percutaneous renal biopsy (PRB) is crucial.
  • While major complications are studied, minor bleeding events like transient hypotension impacting quality of life require more attention.
  • Evidence supporting conventional manual compression post-PRB is limited.

Purpose of the Study:

  • To evaluate the relationship between minor and major complications after PRB.
  • To determine the incidence of transient symptomatic hypotension (minor event) with or without manual compression.

Main Methods:

  • Single-center, retrospective study of 456 patients undergoing native PRB.
  • Comparison between a compression group (15 min manual compression, 4h bed rest) and an observation group (2h strict bed rest).
  • Primary outcome: transient symptomatic hypotension.

Main Results:

  • 26 patients experienced transient hypotension (reflex syncope).
  • Symptomatic transient hypotension was significantly associated with the compression group (OR 3.27, P=0.0078) even after multivariate analysis.
  • Manual compression and abdominal bandage increased the frequency of reflex syncope.

Conclusions:

  • Manual compression and abdominal bandage significantly increase reflex syncope frequency during native PRB.
  • The potential benefits and risks of compression maneuvers should be individualized for patients undergoing PRB.