A recent study conducted in Mali has shed light on the feasibility and safety of percutaneous renal biopsy (PBR) in the country's nephrology practice. The 32-month retrospective study, which took place from November 2017 to June 2020, was conducted in two Bamako hospitals and involved 35 patients who underwent PBR for specific indications. The study aimed to describe the initial experience with PBR in Malian adults and assess its diagnostic yield and complications.
The study population had a mean age of 35.0 years, with a range of 16 to 70 years, and a male predominance of 65.7%. The most frequent clinical manifestation was oedematous syndrome, observed in 57.1% of cases, while proteinuria was abundant in 68.6% of cases. Nephrotic syndrome was the leading indication for PBR, accounting for 54.4% of cases. These findings suggest that PBR is a valuable diagnostic tool for kidney diseases in Malian adults.
The study found that all biopsies were successfully performed using an ultrasound-guided automatic 16-gauge needle. However, complications did occur, including macroscopic haematuria in 11.4% of cases, one death from haemorrhagic shock (2.9%), and one case of acute post-biopsy renal failure (2.9%). Additionally, 14.3% of biopsies were aglomerular, and adequate cortical tissue was obtained in 70% of cases. These results highlight the need for improved training and access to histopathology to enhance diagnostic yield.
The main histological diagnoses in the study were focal segmental glomerulosclerosis (23.3%), membranous glomerulopathy (20.0%), minimal change disease (16.7%), lupus nephritis (10.0%), and IgA nephropathy (3.3%). These findings are consistent with previous studies on kidney diseases in African populations. The study's results suggest that PBR is a valuable tool for diagnosing and managing kidney diseases in Mali.
The study's authors conclude that PBR is feasible in Mali with acceptable complication rates, although sample adequacy remains suboptimal. They emphasize the need for improved training, real-time ultrasound guidance, and access to histopathology to enhance diagnostic yield. These recommendations are crucial for ensuring the safe and effective use of PBR in Malian nephrology practice.
The study's findings have implications for the management of kidney diseases in Mali and other developing countries. The results suggest that PBR can be a valuable diagnostic tool in resource-limited settings, provided that adequate training and equipment are available. Further studies are needed to assess the long-term outcomes of PBR in Malian patients and to evaluate the cost-effectiveness of this diagnostic approach.
The study was conducted by Djiguiba et al. and was published in the journal Health Sciences and Diseases. The authors' work highlights the importance of PBR in the diagnosis and management of kidney diseases in Mali and underscores the need for continued research and development in this area. The study's results contribute to the growing body of evidence on the safety and efficacy of PBR in African populations.
Key points
- - The study found that renal biopsy is feasible in Mali with acceptable complication rates. - The main histological diagnoses were focal segmental glomerulosclerosis, membranous glomerulopathy, and minimal change disease. - Improved training, real-time ultrasound guidance, and access to histopathology are needed to enhance diagnostic yield.
