Clinical risk factors associated with bleeding after native kidney biopsy

• Published in: Nephrology (Carlton, Vic.) Vol. 10; no. 3; pp. 305 - 310
• Main Authors: SHIDHAM, GANESH B, SIDDIQI, NAUMAN, BERES, JOSEPH A, LOGAN, BRENT, NAGARAJA, HN, SHIDHAM, SHUBHANGI G, PIERING, WALTER F
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Science Pty 01.06.2005
• Subjects: Adult; Biopsy - adverse effects; Biopsy - statistics & numerical data; Blood Pressure; Creatinine - blood; Female; Hemorrhage - epidemiology; Hemorrhage - etiology; Humans; hypertension; Hypertension, Renal - epidemiology; Hypertension, Renal - pathology; Kidney Diseases - epidemiology; Kidney Diseases - pathology; Male; mean arterial pressure; Middle Aged; native kidney biopsy; postbiopsy bleeding; Retrospective Studies; Risk Factors; serum creatinine
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/j.1440-1797.2005.00394.x

Purpose:  To determine the effect of various risk factors on postbiopsy bleeding (PBB). Procedure:  A retrospective review of 645 native kidney biopsies carried out from 1981 to 2001 was conducted. Data regarding age, gender, race, prebiopsy blood pressure, history of hypertension, pre‐ and postbiopsy haemoglobin/haematocrit, serum creatinine and blood urea nitrogen (BUN) were collected. Findings:  The overall PBB complication rate was 6.2%. High blood pressure was associated with a high risk of bleeding (test for trend, P < 0.05). It increased when systolic blood pressure (SBP) was >160 mm of Hg, diastolic blood pressure (DBP) was >100 mm of Hg, or mean arterial pressure (MAP) was ≥120 mm of Hg. In patients with a history of hypertension, the risk of PBB was 3.74 times higher (P = 0.0001) than patients with no history of hypertension, irrespective of blood pressure at the time of biopsy. For patients with creatinine >2 mg/dL, the risk ratio for PBB was 5.89 when compared with patients with creatinine ≤2 mg/dL. Logistic regression analysis showed that a history of hypertension was associated with PBB, with an odds ratio of 1.89 (confidence interval, 1.10–3.26, P < 0.03), and serum creatinine of >2.0 mg/dL was associated with an odds ratio of 2.56 (confidence interval, 1.48–4.42, P = 0.001) for PBB. Conclusions:  The risk of PBB increases with high SBP, DBP or MAP. A history of hypertension and high serum creatinine are significant independent risk factors for PBB.