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Risk Factors for Severe Bleeding Complications in Percutaneous Renal Biopsy
Da-Min Xu1, Min Chen1, Fu-de Zhou1
1Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, China; Key Laboratory of Renal Disease, National Health and Family Planning Commission of the People׳s Republic of China, Beijing, PR China.
Insights
Severe bleeding after kidney biopsy is rare. Lower platelet counts and worse renal function increase bleeding risk in Chinese patients undergoing percutaneous renal biopsy.
Area of Science:
- Nephrology
- Internal Medicine
- Medical Diagnostics
Background:
- Percutaneous renal biopsy is crucial for diagnosing kidney diseases.
- Limited data exist on bleeding risk factors in the Chinese population.
- This study investigated severe post-biopsy bleeding in Chinese patients.
Purpose of the Study:
- To identify risk factors for severe bleeding complications after percutaneous renal biopsy.
- To analyze data from a large cohort of Chinese patients.
Main Methods:
- Retrospective analysis of 3,577 native kidney biopsies (2008-2012).
- Severe bleeding defined as requiring intervention (transfusion or invasive procedure).
- Logistic regression used to determine risk factors.
Main Results:
- 14 severe bleeding events (0.39%) occurred.
- Complicated patients were older with higher blood pressure, lower hemoglobin, lower platelets, and worse renal function.
- Lower platelet count (OR=0.89) and worse estimated glomerular filtration rate (OR=0.96) independently predicted severe bleeding.
Conclusions:
- Worse renal function and lower platelet counts are significant risk factors for severe bleeding post-renal biopsy.
- Findings are crucial for risk stratification and patient management.
Background:
Percutaneous renal biopsy is essential for diagnosis of many renal diseases. Previous studies have revealed a variety of factors associated with bleeding complications of renal biopsy; however, data are not sufficient in the Chinese population. We aimed to investigate the risk factors for severe post-biopsy bleeding events in a large cohort of Chinese patients.
Materials And Methods:
The data of patients who underwent percutaneous renal biopsy from January 2008 to December 2012 were collected. Severe bleeding complication was defined as requiring intervention, including blood transfusion or an invasive procedure (radiological or surgical) due to bleeding. Logistic regression analysis was used to assess risk factors.
Results:
Over the 5-year period, 3,577 native kidney biopsies were performed. Severe bleeding complication occurred in 14 biopsies (0.39%). The patients with complications were older, had higher blood pressure, lower hemoglobin, lower platelet count and worse renal function. Multivariable logistic regression demonstrated that platelet level and the estimated glomerular filtration rate were independently associated with the risk of complications. Each 10 × 109/L increase of platelet count was associated with an 11% decrease of severe bleeding risk (odds ratio = 0.89; 95% CI: 0.80-0.98; P = 0.02). Each 1mL/minute/1.73m2 increase of the estimated glomerular filtration rate was associated with a 4% decrease of severe bleeding risk (odds ratio = 0.96; 95% CI: 0.94-0.99; P = 0.004).
Conclusions:
Patients with worse renal function and lower platelet counts had a higher risk of developing severe bleeding events after renal biopsy.
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