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A multicenter retrospective study of 151 renal biopsies in horses
Authors:Tyner G A  Nolen-Walston R D  Hall T  Palmero J P  Couëtil L  Javsicas L  Stack A  Schott H  Johnson A  Hardefeldt L  Gruntman A  Sommardahl C  Menzies-Gow N  dePedro P  Norman T  Fennell L C  Axon J E  Lindborg S  Aceto H  Boston R  Engiles J
Institution:Large Animal Internal Medicine Center, New Bolton Center, University of Pennsylvania, Kennett Square, PA 19348, USA.
Abstract:Background: Renal biopsies are uncommonly performed in horses and little is known about their diagnostic utility and associated complication rate. Objective: To describe the techniques, the complication rate, risk factors, and histopathology results; as well as evaluate the safety and diagnostic utility of renal biopsy in the horse. Animals: One hundred and forty‐six horses from which 151 renal biopsies were obtained. Animals ranged in age from 48 hours to 30 years. Methods: Multicenter retrospective study, with participation of 14 institutions (1983–2009). Results: Renal biopsy in horses was associated with a similar rate of complications (11.3%) to that occurring in humans and companion animals. Complications were generally associated with hemorrhage or signs of colic, and required treatment in 3% of cases. Fatality rate was low (1/151; 0.7%). Biopsy specimens yielded sufficient tissue for a histopathologic diagnosis in most cases (94%) but diagnoses had only fair (72%) agreement with postmortem findings. Risk factors for complications included biopsy specimens of the left kidney (P= .030), a diagnosis of neoplasia (P= .004), and low urine specific gravity (P= .030). No association with complications was found for age, sex, breed, institution, presenting complaint, other initial clinicopathologic data, biopsy instrument, needle size, or use of ultrasonographic guidance. Conclusions and Clinical Importance: Renal biopsy in horses has low morbidity and results in a morphological histopathologic diagnosis in 94% of cases. However, this procedure might result in serious complications and should only be used when information obtained would be likely to impact decisions regarding patient management and prognosis.
Keywords:Complications  Kidney  Percutaneous  Risk factor
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