Renal biopsies in special situations
La biopsia renal en situaciones especiales
Read
11668
Timeswas read the article
2637
Total PDF
9031
Total HTML
Share statistics
array:20 [ "pii" => "X2013251411000317" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2011.Jun.10925" "estado" => "S300" "fechaPublicacion" => "2011-11-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2011;31:627-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5727 "formatos" => array:3 [ "EPUB" => 313 "HTML" => 4703 "PDF" => 711 ] ] "Traduccion" => array:1 [ "es" => array:17 [ "pii" => "X021169951100031X" "issn" => "02116995" "doi" => "10.3265/Nefrologia.pre2011.Jun.10925" "estado" => "S300" "fechaPublicacion" => "2011-11-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2011;31:627-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 10244 "formatos" => array:3 [ "EPUB" => 308 "HTML" => 9145 "PDF" => 791 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "La biopsia renal en situaciones especiales" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "627" "paginaFinal" => "629" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Renal biopsies in special situations" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. PECES, E. DE SOUSA, C. PECES" "autores" => array:3 [ 0 => array:2 [ "Iniciales" => "R." "apellidos" => "PECES" ] 1 => array:2 [ "Iniciales" => "E." "apellidos" => "DE SOUSA" ] 2 => array:2 [ "Iniciales" => "C." "apellidos" => "PECES" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251411000317" "doi" => "10.3265/Nefrologia.pre2011.Jun.10925" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411000317?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X021169951100031X?idApp=UINPBA000064" "url" => "/02116995/0000003100000006/v0_201502091400/X021169951100031X/v0_201502091400/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X2013251411000309" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2011.Oct.11015" "estado" => "S300" "fechaPublicacion" => "2011-11-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2011;31:630-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7266 "formatos" => array:3 [ "EPUB" => 331 "HTML" => 6039 "PDF" => 896 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Evolution and applications of bioimpedance in managing chronic kidney disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "630" "paginaFinal" => "634" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evolución y aplicaciones de la bioimpedancia en el manejo de la enfermedad renal crónica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "11015_108_25141_en_f1_11015.jpg" "Alto" => 398 "Ancho" => 600 "Tamanyo" => 74345 ] ] "descripcion" => array:1 [ "en" => "Vector components of electrical impedance (Z). Xc = reactance; R: resistance; g: phase angleVector components of electrical impedance (Z). Xc = reactance; R: resistance; g: phase angle" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. López-Gómez" "autores" => array:1 [ 0 => array:2 [ "Iniciales" => "J.M." "apellidos" => "López-Gómez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699511000301" "doi" => "10.3265/Nefrologia.pre2011.Oct.11015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699511000301?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411000309?idApp=UINPBA000064" "url" => "/20132514/0000003100000006/v0_201502091623/X2013251411000309/v0_201502091623/en/main.assets" ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Renal biopsies in special situations" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "627" "paginaFinal" => "629" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "R. PECES, E. DE SOUSA, C. PECES" "autores" => array:3 [ 0 => array:3 [ "Iniciales" => "R." "apellidos" => "PECES" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "Iniciales" => "E." "apellidos" => "DE SOUSA" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "Iniciales" => "C." "apellidos" => "PECES" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario La Paz, IdiPaz, Madrid, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Área de Tecnología de la Información, SESCAM, Toledo, " "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La biopsia renal en situaciones especiales" ] ] "textoCompleto" => "<p class="elsevierStylePara">Renal biopsies are immensely valuable tools for the diagnosis, prognosis, and treatment of kidney disease patients. The first mention of a percutaneous renal biopsy is from 1950, and was published by the Cuban doctor Antonio Pérez Ara in a local journal.<span class="elsevierStyleSup">1</span> In Spain, the first communications of renal biopsies date from 1958. Since then, this practice has been extended to many hospitals in Spain and all over the world.<span class="elsevierStyleSup">1</span> A cost-benefit analysis of renal biopsies yields very positive results since this procedure allows the identification of a wide range of renal anomalies. Among the situations for which renal biopsies provide particular advantages are renal diseases of unknown origin, glomerular proteinuria and haematuria, urine sediment abnormalities, interstitial diseases, and transplant-related pathologies. However, it is an invasive examination procedure, and should only be indicated on an individual basis, depending on the patient characteristics and after careful consideration of the risks and benefits for each particular case.<span class="elsevierStyleSup">2</span> Apparently simple renal diseases can sometimes turn to be complex situations in which several diseases can be associated. This is the case in autosomal dominant polycystic kidney disease (ADPKD), which is associated with a nephrotic syndrome. Only a histological study is capable of determining the presence of apparently pathogenic glomerular damage independent of the primary process, which corresponds to degenerative cystic changes in the renal parenchyma.<span class="elsevierStyleSup">3</span></p><p class="elsevierStylePara">Percutaneous renal biopsies are well established as a safe and effective technique for obtaining samples of renal parenchyma.<span class="elsevierStyleSup">4,5</span> With the appearance of new technologies, such as the use of real-time ultrasonography (US) for guiding the procedure and the use of automatic biopsy needles, the success rate has improved to 95% of cases.<span class="elsevierStyleSup">5</span> US allows for localising the lower pole of kidney, determining the size of the kidney, and detecting the presence of large cysts that may require the use of the contralateral kidney. Computerised tomography (CT)-guided percutaneous renal biopsy is an alternative when the kidneys cannot be properly visualised, such as in the case of obesity or small and echogenic kidneys. Complications, although rare, are associated with haemorrhages in the majority of cases. However, absolute and relative contraindications for the percutaneous approach do exist: single kidney, uncontrolled arterial hypertension, haemostasis disorders, aneurysms in the renal artery, Jehovah’s witnesses, failed percutaneous needle biopsy, morbid obesity, and non-compliant patients. Recently, the results from a study of 867 US-guided renal biopsies in native kidneys over 18 years were published, with one retrospective group of 797 biopsies and a prospective group of 70 biopsies performed over the course of one year.<span class="elsevierStyleSup">6</span> This study reported a rate of major complications of 1.4%, and 2% for minor complications. The most common major complications were related to patients with a predisposition to bleeding and those with hepatopathies.<span class="elsevierStyleSup">6</span> The cumulative experience gained in recent decades has demonstrated that percutaneous renal biopsy is a safe technique in the majority of cases, except in obese patients, which constitute an increasing percentage of the population in developed countries. Obese patients are at a greater risk for complications such as haemorrhage, failure of the technique, severe respiratory difficulties, and poor visualisation of the kidneys due to large body mass.<span class="elsevierStyleSup">7</span> Alternative methods have been attempted for obtaining samples of kidney tissue samples in patients with contraindications for the percutaneous approach. In these situations, an open renal biopsy through a posterior or flank (lumbotomy) incision is a viable option. Since multiple bilateral renal cysts are a relative contraindication for the percutaneous approach due to the risk of complications and the difficulty in obtaining adequate tissue samples, the majority of patients with ADPKD are eligible for the open approach.<span class="elsevierStyleSup">8-10</span> Only isolated references exist of renal cysts in the medical literature, with no studies or clinical trials published on the subject. Only a few cases of ADPKD have undergone US- or CT-guided biopsies without complications.<span class="elsevierStyleSup">11</span> The experience with this technique is very limited, hindering its regular use as a safe option.</p><p class="elsevierStylePara">Although open or surgical renal biopsies have been performed for over 40 years as a standard procedure in patients with contraindications for the percutaneous approach, there are other less invasive alternatives.<span class="elsevierStyleSup">4,12-16</span> Transvenous biopsies use native vessels as an alternative route for arriving at the organ in question. The tissue sample is obtained by passing a needle through the wall of the vein into the adjacent parenchyma.<span class="elsevierStyleSup">12-15</span> The most common indications for performing a transjugular renal biopsy are patients with haemostasis disorders and those under anticoagulant treatment, in whom a histological diagnosis is necessary for determining the proper course of treatment.<span class="elsevierStyleSup">17</span> The theoretical advantages are that bleeding occurs within the interior of the vein, the needle avoids the larger vessels of the organ instead of being directed towards them, and there is a reduced probability of capsular perforation. The disadvantages include a small tissue sample size (which in turn reduces the possibility of obtaining a histological diagnosis) and the limited availability of this technique due to the absence of sufficiently trained medical personnel. The transjugular approach (as well as the femoral one) is a procedure that cannot be considered a routine approach due to limitations in infrastructure, personnel, costs, and time.<span class="elsevierStyleSup">15,17</span> The transurethral approach is little more than an anecdotal alternative.<span class="elsevierStyleSup">16</span> Laparoscopic renal biopsies can be performed using a retroperitoneal (retroperitoneoscopy)<span class="elsevierStyleSup">18-20</span> or transperitoneal<span class="elsevierStyleSup">21</span> approach. These biopsy methods provide advantages, as they allow for identification of the kidney, and the biopsy and haemostasis can be performed under direct visualisation. Additionally, the retroperitoneal laparoscopic approach is minimally invasive, with very short patient recovery and convalescence times in the majority of cases.<span class="elsevierStyleSup">18,20,22</span> Furthermore, it can be performed as an outpatient procedure in most cases. For these reasons, the retroperitoneal laparoscopic approach has gained popularity in Spain and the rest of the world, and is indicated in paediatric cases.<span class="elsevierStyleSup">23,24</span> The retroperitoneoscopy or transperitoneal renal biopsy is in fact the currently recommended procedure for paediatric cases.<span class="elsevierStyleSup">25</span> Recently, a technique has been proposed that combines the laparoscopic approach with a percutaneous needle biopsy.<span class="elsevierStyleSup">26</span> This approach combines the advantages of the percutaneous biopsy with the minimal trauma and low morbidity associated with laparoscopic procedures. Although laparoscopic surgery is highly effective and is associated with high success rates and minimal morbidity in the treatment of cystic kidney diseases,<span class="elsevierStyleSup">27</span> a literature review only found a few publications of patients with multiple bilateral renal cysts that had undergone a laparoscopic renal biopsy. In conclusion, the laparoscopic approach offers a good cost-benefit ratio for complex cases that require a renal biopsy. Using this technique, direct access to the organ allows for a direct selection of the tissue to be taken for biopsy as well as protection against damage to surrounding structures during the procedure, thus ensuring haemostasis.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">KEY CONCEPTS</span></p><p class="elsevierStylePara">1. There are several absolute and relative contraindications for percutaneous renal biopsies, such as single kidney, uncontrolled arterial hypertension, haemostasis disorders, aneurysms in the renal artery, Jehovah’s witnesses, failed percutaneous needle biopsy, morbid obesity, and non-compliant patients.</p><p class="elsevierStylePara">2. In complex situations requiring a renal biopsy (e.g., kidneys with multiple cysts), the laparoscopic approach allows for allows for a direct selection of the tissue to be taken for biopsy as well as protection against damage to surrounding structures during the procedure, thus ensuring haemostasis.</p><p class="elsevierStylePara">3. Renal biopsies using the retroperitoneoscopy technique are the current procedure of choice in paediatric patients.</p>" "pdfFichero" => "P1-E528-S3200-A10925-EN.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "García Nieto V, Luis Yanes MI, Ruiz Pons M. En el cincuentenario de las primeras biopsias renales percutáneas realizadas en España. Nefrologia 2009;29:71-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19240775" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Rivera Gorrin M. Ultrasound-guided renal biopsy. Nefrologia 2010;30:490-2. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20882089" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Peces R, Martínez-Ara J, Peces C, Picazo M, Cuesta-López E, Vega C, et al.\u{A0}Nephrotic syndrome and idiopathic membranous nephropathy associated with autosomal-dominant polycystic kidney disease. The Scientific World Journal 2011;11:1041-7" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Jackman SV, Bishoff JT. Laparoscopic retroperitoneal renal biopsy. J Endourol 2000;14:833-8." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Whittier WL, Korbet SM. Renal biopsy: update. Curr Opin Nephrol Hypertens 2004;13:661-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15483458" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Toledo K, Pérez MJ, Espinoza M, Gómez J, López M, Redondo D, et al.\u{A0}Complications associated with percutaneous renal biopsy in Spain, 50 years later. Nefrologia 2010;30:490-2. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20882089" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Gesualdo L, Cormio L, Stallone G, Infante B, Di Palma AM. Percutaneous ultrasound-guided renal biopsy in supine antero-lateral position: A new approach for obese and non-obese patients. Nephrol Dial Transplant 2008;23:971-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17977877" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Contreras G, Mercado A, Pardo V, Vaamonde CA. Nephrotic syndrome in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 1995;6:1354-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8589309" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Hiura T, Yamazaki H, Saeki T, Kawabe S, Ueno M, Nishi S, et al.\u{A0}Nephrotic syndrome and IgA nephropathy in polycystic kidney disease. Clin Exp Nephrol 2006;10:136-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16791401" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Wan RK, Kipgen D, Morris S, Rodger RSC. A rare cause of nephrotic syndrome in autosomal dominant polycystic kidney disease. Nephrol Dial Transplant PLUS 2009;2:136-8." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "D'Cruz S, Singh R, Mohan H, Kaur R, Minz RW, Kapoor V, et al.\u{A0}Autosomal dominant polycystic kidney disease with diffuse proliferative glomerulonephritis-an unusual association: a case report and review of the literature. J Med Case Rep 2010;4:125. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20429898" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Stiles KP, Yuan CM, Chung EM, Lyon RD, Lane JD, Abbott KC. Renal biopsy in high-risk patients with medical diseases of the kidney. Am J Kidney Dis 2000;36:419-33. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10922324" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Misra S, Gyamlani G, Swaminathan S, Buehrig CK, Bjarnason H, McKusick MA, et al.\u{A0}Safety and diagnostic yield of transjugular renal biopsy. J Vasc Interv Radiol 2008;19:546-51. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18375299" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "See TC, Thompson BC, Howie AJ, Karamshi M, Papadopoulou AM, Davies N, et al.\u{A0}Transjugular renal biopsy: our experience and technical considerations. Cardiovasc Intervent Radiol 2008;31:906-18. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18266029" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Bilbao JI, Arias M, Herrero JI, Iglesias A, Martínez Regueria F, Alajandre PL, et al.\u{A0}Renal biopsy with forceps through femoral vein. Cardiovasc Intervent Radiol 1995;18:232-6." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Leal JJ. A new technique for renal biopsy: the transurethral approach. J Urol 1993;149:1061-3. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8483210" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Meyrier A. Transjugular renal biopsy. Update on hepato-renal needlework. Nephrol Dial Transplant 2005;20:1299-302. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15870228" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Giménez LF, Micali S, Chen RN, Moore RG, Kavoussi LR, Scheel PJ. Laparoscopic renal biopsy. Kidney Int 1998;54:525-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9690219" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Gupta M, Haluck RS, Yang HC, Holman MJ, Ahsan N. Laparoscopic-assisted renal biopsy: an alternative to open approach. Am J Kidney Dis 2000;36:636-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10977798" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Shetye KR, Kavoussi LR, Ramakumar S, Fugita OE, Jarrett TW. Laparoscopic renal biopsy: a 9-year experience. BJU Int 2003;91:817-20. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12780840" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Anas CM, Hattori R, Morita Y, Matsukawa Y, Komatsu T, Yoshino Y, et al.\u{A0}Efficiency of laparoscopic-assisted renal biopsy. Clin Nephrol 2008;70:203-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18793561" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Uppot RN, Harisinghani MG, Gervais DA. Imaging-guided percutaneous renal biopsy: rationale and approach. AJR Am J Roentgenol 2010;194:1443-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20489082" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Luque Mialdea R, Martín-Crespo Izquierdo R, Díaz L, Fernández A, Morales D, Cebrián J. Renal biopsy through a retroperitoneoscopic approach: our experience in 53 pediatric patients. Arch Esp Urol 2006;59:799-803. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17153499" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Caione P, Micali S, Rinaldi S, Capozza N, Lais A, Matarazzo E,\u{A0}et al. Retroperitoneal laparoscopy for renal biopsy in children. J Urol 2000; 164:1080-3." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Jesus CM, Yamamoto H, Kawano PR, Otsuka R, Fugita OE. Retroperitoneoscopic renal biopsy in children. Int Braz J Urol 2007;33:536-41." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Bastos Netto JM, Portela WS, Choi M, Filho MF, De Toledo AC, Figueiredo AA. Laparoscopic-percutaneous kidney biopsy in children-a new approach. J Pediatr Surg 2009;44:2058-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19853775" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Agarwal MM, Hemal AK. Surgical management of renal cystic disease. Curr Urol Rep 2011;12:3-10. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21107921" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003100000006/v0_201502091623/X2013251411000317/v0_201502091623/en/main.assets" "Apartado" => array:4 [ "identificador" => "35429" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorials" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003100000006/v0_201502091623/X2013251411000317/v0_201502091623/en/P1-E528-S3200-A10925-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411000317?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 13 | 22 |
| 2024 October | 69 | 68 | 137 |
| 2024 September | 67 | 29 | 96 |
| 2024 August | 95 | 56 | 151 |
| 2024 July | 68 | 30 | 98 |
| 2024 June | 91 | 66 | 157 |
| 2024 May | 93 | 47 | 140 |
| 2024 April | 71 | 46 | 117 |
| 2024 March | 69 | 25 | 94 |
| 2024 February | 69 | 34 | 103 |
| 2024 January | 71 | 25 | 96 |
| 2023 December | 50 | 29 | 79 |
| 2023 November | 81 | 36 | 117 |
| 2023 October | 96 | 48 | 144 |
| 2023 September | 98 | 34 | 132 |
| 2023 August | 91 | 20 | 111 |
| 2023 July | 85 | 40 | 125 |
| 2023 June | 89 | 17 | 106 |
| 2023 May | 90 | 30 | 120 |
| 2023 April | 98 | 19 | 117 |
| 2023 March | 88 | 26 | 114 |
| 2023 February | 102 | 26 | 128 |
| 2023 January | 72 | 23 | 95 |
| 2022 December | 76 | 39 | 115 |
| 2022 November | 70 | 31 | 101 |
| 2022 October | 78 | 49 | 127 |
| 2022 September | 92 | 31 | 123 |
| 2022 August | 81 | 48 | 129 |
| 2022 July | 54 | 36 | 90 |
| 2022 June | 73 | 41 | 114 |
| 2022 May | 64 | 35 | 99 |
| 2022 April | 66 | 65 | 131 |
| 2022 March | 119 | 49 | 168 |
| 2022 February | 107 | 39 | 146 |
| 2022 January | 68 | 33 | 101 |
| 2021 December | 83 | 39 | 122 |
| 2021 November | 74 | 33 | 107 |
| 2021 October | 88 | 52 | 140 |
| 2021 September | 67 | 36 | 103 |
| 2021 August | 73 | 46 | 119 |
| 2021 July | 63 | 27 | 90 |
| 2021 June | 61 | 34 | 95 |
| 2021 May | 87 | 49 | 136 |
| 2021 April | 187 | 73 | 260 |
| 2021 March | 103 | 65 | 168 |
| 2021 February | 54 | 13 | 67 |
| 2021 January | 70 | 19 | 89 |
| 2020 December | 69 | 17 | 86 |
| 2020 November | 60 | 15 | 75 |
| 2020 October | 41 | 18 | 59 |
| 2020 September | 50 | 14 | 64 |
| 2020 August | 53 | 13 | 66 |
| 2020 July | 45 | 14 | 59 |
| 2020 June | 39 | 15 | 54 |
| 2020 May | 80 | 12 | 92 |
| 2020 April | 53 | 19 | 72 |
| 2020 March | 46 | 12 | 58 |
| 2020 February | 49 | 18 | 67 |
| 2020 January | 72 | 31 | 103 |
| 2019 December | 73 | 25 | 98 |
| 2019 November | 68 | 25 | 93 |
| 2019 October | 67 | 13 | 80 |
| 2019 September | 64 | 28 | 92 |
| 2019 August | 64 | 24 | 88 |
| 2019 July | 74 | 20 | 94 |
| 2019 June | 53 | 17 | 70 |
| 2019 May | 59 | 19 | 78 |
| 2019 April | 91 | 30 | 121 |
| 2019 March | 64 | 35 | 99 |
| 2019 February | 50 | 20 | 70 |
| 2019 January | 60 | 16 | 76 |
| 2018 December | 104 | 35 | 139 |
| 2018 November | 157 | 17 | 174 |
| 2018 October | 116 | 21 | 137 |
| 2018 September | 101 | 14 | 115 |
| 2018 August | 70 | 15 | 85 |
| 2018 July | 51 | 9 | 60 |
| 2018 June | 57 | 16 | 73 |
| 2018 May | 60 | 12 | 72 |
| 2018 April | 65 | 9 | 74 |
| 2018 March | 53 | 19 | 72 |
| 2018 February | 48 | 9 | 57 |
| 2018 January | 50 | 10 | 60 |
| 2017 December | 52 | 14 | 66 |
| 2017 November | 54 | 11 | 65 |
| 2017 October | 61 | 8 | 69 |
| 2017 September | 51 | 12 | 63 |
| 2017 August | 60 | 6 | 66 |
| 2017 July | 48 | 11 | 59 |
| 2017 June | 57 | 24 | 81 |
| 2017 May | 58 | 13 | 71 |
| 2017 April | 48 | 18 | 66 |
| 2017 March | 33 | 6 | 39 |
| 2017 February | 37 | 10 | 47 |
| 2017 January | 45 | 12 | 57 |
| 2016 December | 65 | 10 | 75 |
| 2016 November | 105 | 10 | 115 |
| 2016 October | 115 | 27 | 142 |
| 2016 September | 128 | 3 | 131 |
| 2016 August | 229 | 10 | 239 |
| 2016 July | 243 | 7 | 250 |
| 2016 June | 136 | 0 | 136 |
| 2016 May | 157 | 0 | 157 |
| 2016 April | 122 | 0 | 122 |
| 2016 March | 94 | 0 | 94 |
| 2016 February | 110 | 0 | 110 |
| 2016 January | 97 | 0 | 97 |
| 2015 December | 111 | 0 | 111 |
| 2015 November | 89 | 0 | 89 |
| 2015 October | 100 | 0 | 100 |
| 2015 September | 139 | 0 | 139 |
| 2015 August | 72 | 0 | 72 |
| 2015 July | 64 | 0 | 64 |
| 2015 June | 38 | 0 | 38 |
| 2015 May | 55 | 0 | 55 |
| 2015 April | 12 | 0 | 12 |
Show all
