What are the guideline sources, guidelines and references for Renal biopsy ?
Guideline sources The following summarized guidelines for the evaluation and management of renal biopsy are prepared by our editorial team based on guidelines from the Kidney Health Australia (KHA 2019). 1 Guidelines 1. Diagnostic procedures Patient positioning: consider using the supine anterolateral position for native renal biopsy in patients with obesity or respiratory difficulty. C Show 3 more Needle selection: use a spring-loaded automatic needle device for native B and transplant renal biopsy, because it is associated with fewer complications and better tissue samples. B Show 2 more Image guidance: use image guidance for percutaneous native renal biopsy. B Show 3 more 2. Inpatient care https://web.pathway.md/diseases/reccvZayHYhufVJLn 1/3 6/24/23, 2:57 PM Renal biopsy Pathway Post-biopsy monitoring: keep the patient in hospital following a renal biopsy for strict bed-rest with frequent observations for 6-24 hours. Offer a 6-8 hours period of observation with same day discharge in low-risk patients. B Show 5 more Management of post-biopsy bleeding: consider administering initial IV crystalloid or colloid fluids in patients with moderate-to-severe bleeding, indicated by severe pain, large perinephric hematoma and/or post-biopsy hypotension. C Show 3 more 3. Patient education Patient education (pre-biopsy): Educate and inform patients and their carers about renal biopsies including reasons for its use, risks and complications, pre- and post-biopsy management with particular regard to psychological issues such as anxiety. Provide education and information in a format suited to their learning needs. B Consider following the process outlined below to establish methods of communication and interaction with patients undergoing renal biopsy, to adequately prepare them for the procedure and alleviate unnecessary anxiety throughout the process: Situation Guidance Establish a visit plan Pre-biopsy Deliver information for self-management pre-/post-procedure Conduct thorough consent process outlining risks and necessity for biopsy Admission - explain expected schedule Biopsy Pre-procedure - explain restrictions/timing (moving, eating, voiding), contact caregiver Recovery - check in with patient at expected time Discharge - explain post-procedure care, notify caregiver All - keep informed of delays, multidisciplinary communication to manage comorbid conditions Deliver results as soon as possible. Post-biopsy https://web.pathway.md/diseases/reccvZayHYhufVJLn 2/3 6/24/23, 2:57 PM Renal biopsy Pathway Patient education (post-biopsy): provide patients at discharge with clear written instructions for post-biopsy care, for return to work and exercise, and with unit/department/hospital contacts in case of emergency. Show 2 more 4. Preventative measures Prevention of post-biopsy bleeding (discontinuation of antiplatelet and anticoagulant therapy): continue aspirin in patients with high cardiovascular risks, including patients with coronary stents (particularly within 3 months of bare metal stent or 12 months of drug-eluting stent insertion), symptomatic myocardial ischemia or peripheral vascular disease (including patients with a peripheral stent), or previous ischemic stroke. B Show 5 more Prevention of post-biopsy bleeding (desmopressin): insufficient evidence to support for or against the use of desmopressin for the prevention of post-biopsy bleeding. Show 3 more References 1. Rob MacGinley, Paul J Champion De Crespigny, Talia Gutman et al. KHA CARI Guideline recommendations for renal biopsy. Nephrology Carlton). 2019 Dec;24 12 1205 1213. Open https://web.pathway.md/diseases/reccvZayHYhufVJLn 3/3