The safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron mass
BackgroundPercutaneous renal biopsy (PRB) provides valuable information to guide treatment decisions in patients with metastatic renal cell carcinoma (mRCC) who develop acute kidney injury (AKI) after systemic anticancer therapy (SACT). The rising incidence of renal cell carcinoma (RCC) and the subs...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Nephrology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneph.2025.1615779/full |
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| author | Tomaz Milanez Tomaz Milanez Vinay Srinivasan Vladimir Premru Miha Arnol Miha Arnol Janja Ocvirk Edgar A. Jaimes Edgar A. Jaimes |
| author_facet | Tomaz Milanez Tomaz Milanez Vinay Srinivasan Vladimir Premru Miha Arnol Miha Arnol Janja Ocvirk Edgar A. Jaimes Edgar A. Jaimes |
| author_sort | Tomaz Milanez |
| collection | DOAJ |
| description | BackgroundPercutaneous renal biopsy (PRB) provides valuable information to guide treatment decisions in patients with metastatic renal cell carcinoma (mRCC) who develop acute kidney injury (AKI) after systemic anticancer therapy (SACT). The rising incidence of renal cell carcinoma (RCC) and the substantial impact of SACT on overall survival suggest a higher prevalence of RCC patients with reduced nephron mass and a solitary kidney (SK) requiring PRB for AKI. However, safety data on SK biopsies are scarce, and the potential for dialysis-requiring complications may deter clinicians.MethodsThis retrospective case series reports the safety of 13 PRBs in 12 mRCC patients with reduced nephron mass who developed AKI during SACT as well as six PRBs in six patients with metastatic solid malignancies and AKI, which developed during SACT.ResultsEleven biopsies in mRCC patients and five biopsies in patients with metastatic solid malignancies were uneventful. One patient with mRCC experienced a major bleeding event due to an arteriovenous (AV) fistula seven days post-procedure, while another mRCC patient developed macrohematuria within 24 hours. In the group of patients with metastatic solid malignancies, one patient experienced a small perinephric hematoma during the observational period. Despite the small sample size, individual chart reviews and direct management of adverse events allowed assessment of the association between biopsy and complications.ConclusionUntil further data become available, a longer observation period is recommended for these patient cohorts compared to the general population. Further studies are needed to develop consensus guidelines for PRB in mRCC patients with reduced nephron mass. |
| format | Article |
| id | doaj-art-b0119bb340bd402a9754c4aa0b85fc9b |
| institution | Kabale University |
| issn | 2813-0626 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nephrology |
| spelling | doaj-art-b0119bb340bd402a9754c4aa0b85fc9b2025-08-20T03:39:29ZengFrontiers Media S.A.Frontiers in Nephrology2813-06262025-08-01510.3389/fneph.2025.16157791615779The safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron massTomaz Milanez0Tomaz Milanez1Vinay Srinivasan2Vladimir Premru3Miha Arnol4Miha Arnol5Janja Ocvirk6Edgar A. Jaimes7Edgar A. Jaimes8Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, SloveniaDepartment of Nephrology, University Medical Center Ljubljana, Ljubljana, SloveniaDivision of Nephrology, Cooper University Hospital and Cooper Medical School of Rowan University, Camden, NJ, United StatesDepartment of Nephrology, University Medical Center Ljubljana, Ljubljana, SloveniaDepartment of Nephrology, University Medical Center Ljubljana, Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, Ljubljana, SloveniaDivision of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, SloveniaRenal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United StatesWeill Cornell Medical College, New York, NY, United StatesBackgroundPercutaneous renal biopsy (PRB) provides valuable information to guide treatment decisions in patients with metastatic renal cell carcinoma (mRCC) who develop acute kidney injury (AKI) after systemic anticancer therapy (SACT). The rising incidence of renal cell carcinoma (RCC) and the substantial impact of SACT on overall survival suggest a higher prevalence of RCC patients with reduced nephron mass and a solitary kidney (SK) requiring PRB for AKI. However, safety data on SK biopsies are scarce, and the potential for dialysis-requiring complications may deter clinicians.MethodsThis retrospective case series reports the safety of 13 PRBs in 12 mRCC patients with reduced nephron mass who developed AKI during SACT as well as six PRBs in six patients with metastatic solid malignancies and AKI, which developed during SACT.ResultsEleven biopsies in mRCC patients and five biopsies in patients with metastatic solid malignancies were uneventful. One patient with mRCC experienced a major bleeding event due to an arteriovenous (AV) fistula seven days post-procedure, while another mRCC patient developed macrohematuria within 24 hours. In the group of patients with metastatic solid malignancies, one patient experienced a small perinephric hematoma during the observational period. Despite the small sample size, individual chart reviews and direct management of adverse events allowed assessment of the association between biopsy and complications.ConclusionUntil further data become available, a longer observation period is recommended for these patient cohorts compared to the general population. Further studies are needed to develop consensus guidelines for PRB in mRCC patients with reduced nephron mass.https://www.frontiersin.org/articles/10.3389/fneph.2025.1615779/fullacute kidney injurycomplicationsrenal biopsyrenal cell carcinomasolitary kidney |
| spellingShingle | Tomaz Milanez Tomaz Milanez Vinay Srinivasan Vladimir Premru Miha Arnol Miha Arnol Janja Ocvirk Edgar A. Jaimes Edgar A. Jaimes The safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron mass Frontiers in Nephrology acute kidney injury complications renal biopsy renal cell carcinoma solitary kidney |
| title | The safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron mass |
| title_full | The safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron mass |
| title_fullStr | The safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron mass |
| title_full_unstemmed | The safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron mass |
| title_short | The safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron mass |
| title_sort | safety of percutaneous renal biopsy for acute kidney injury in metastatic renal cell cancer patients with reduced nephron mass |
| topic | acute kidney injury complications renal biopsy renal cell carcinoma solitary kidney |
| url | https://www.frontiersin.org/articles/10.3389/fneph.2025.1615779/full |
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