Estimation of risk for major bleeding in native kidney biopsies in patients with multiple risk factors

Background and aims Individuals undergoing kidney biopsy are increasingly older and may have concurrent illnesses that cause deranged hematological and renal parameters that are associated with post-biopsy bleeding. We aimed to develop a clinical risk model to quantify bleeding risks in high-risk in...

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Bibliographic Details
Published in:International urology and nephrology 2022-02, Vol.54 (2), p.343-348
Main Authors: Lim, Cynthia C., Tan, Ru Yu, Choo, Jason C. J., Tan, Hui Zhuan, Mok, Irene, Chin, Yok Mooi, Tan, Chieh Suai
Format: Article
Language:English
Subjects:
Adult
Aged
Biopsy
Bleeding
Cohort Studies
Creatinine
Female
Hemoglobin
Humans
Image-Guided Biopsy - adverse effects
Kidney - pathology
Kidneys
Male
Medicine
Medicine & Public Health
Middle Aged
Multivariate analysis
Nephrology
Nephrology - Original Paper
Platelets
Postoperative Hemorrhage - epidemiology
Postoperative Hemorrhage - etiology
Prothrombin
Retrospective Studies
Risk Assessment
Risk Factors
Urology
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Summary:Background and aims Individuals undergoing kidney biopsy are increasingly older and may have concurrent illnesses that cause deranged hematological and renal parameters that are associated with post-biopsy bleeding. We aimed to develop a clinical risk model to quantify bleeding risks in high-risk individuals with multiple risk factors. Methods Single-center retrospective cohort study of consecutive adults with serum creatinine ≥ 2 mg/dL (176 µmol/L) and had ultrasound-guided percutaneous native kidney biopsies between June 2011 and July 2015 in our tertiary referral center. The primary outcome was major bleeding, defined as need for red cell transfusion, radiological or surgical intervention, or if bleeding led to death within 7 days after kidney biopsy. Results Among 184 native kidney biopsies with serum creatinine ≥ 2 mg/dL, median age was 54.1 years and eGFR was 18.8 ml/min/1.73 m 2 . Major bleeding occurred in 19 biopsies (10.3%). Multivariate analysis accounting for age, weight, hemoglobin, platelet, prothrombin time and urea found that higher hemoglobin (adjusted OR 0.51, 95% CI 0.33–0.79, p  = 0.003) and platelet (adjusted OR 0.99, 95% CI 0.98–0.99, p  = 0.01) were independently associated with reduced major bleeding. A risk model that included (1) age ≥ 62 years old, (2) hemoglobin 
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-021-02874-y