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Kidney Week

Abstract: FR-PO003

Kidney Biopsy-Related Complications in Hospitalized Patients with Acute Kidney Disease

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Moledina, Dennis G., Yale School of Medicine, New Haven, Connecticut, United States
  • Luciano, Randy L., Yale School of Medicine, New Haven, Connecticut, United States
  • Kukova, Lidiya, Yale School of Medicine, New Haven, Connecticut, United States
  • Chan, Lili, Ichan School of Medicine, New York, New York, United States
  • Saha, Aparna, Ichan School of Medicine, New York, New York, United States
  • Nadkarni, Girish N., Ichan School of Medicine, New York, New York, United States
  • Wilson, Francis Perry, Yale School of Medicine, New Haven, Connecticut, United States
  • Perazella, Mark A., Yale School of Medicine, New Haven, Connecticut, United States
  • Parikh, Chirag R., Yale School of Medicine, New Haven, Connecticut, United States
Background

We used data from the Yale biopsy cohort and Nationwide Inpatient Sample (NIS) to evaluate rates and risk factors of biopsy-related complications including adjudicated procedure-related bleeding requiring blood transfusions or angiographic interventions and death

Methods

We used data from the Yale biopsy cohort and Nationwide Inpatient Sample (NIS) to evaluate rates and risk factors of biopsy-related complications. We looked at complications including adjudicated procedure-related bleeding requiring blood transfusions or angiographic interventions and death

Results

Between 2015-2017, 159 hospitalized patients underwent a kidney biopsy at Yale for AKD evaluation. Median age of participants was 59 (47-68) years, 68 (43%) were women, 80 (51%) had stage 1 AKI, and 42 (27%) had stage 2 or higher AKI. Of these, 12 [9 (5-15)%] required a blood transfusion for biopsy-related bleeding and 3 [2 (1-5)%] required an intervention. Of the 4 [3 (1-6)%] deaths during hospitalization, none were related to the biopsy.
We identified lower hemoglobin and platelet levels, female sex, trainee as proceduralist, and larger needle gauge as risk factors of post-biopsy transfusion (Table). Higher blood urea nitrogen was associated with higher rates of transfusion in patients who did not receive desmopressin [n=32 (20%)], but not in those who received desmopressin (interaction P=0.008). Among the 53,315 hospitalizations with kidney biopsies between 2012-2014 in the NIS, 925 (2%) required an intervention, similarly to the Yale cohort (P=0.88).

Conclusion

Hospitalized patients experience higher risk of post-biopsy complications and several risk factors such as lower hemoglobin and platelet count, female sex, and larger needle gauge are associated with this risk.

Risk factors for post-biopsy bleeding requiring blood transfusion
Risk factorBiopsy-related Transfusion (N=12)No Biopsy-related Transfusion (N=147)P-value*
Platelet count112 (86, 189)209 (150, 285)0.003
Hemoglobin level8.5 (7.4, 8.7)9.4 (8.1, 10.4)0.007
Female9 (75%)59 (40%)0.02
BUN (No desmopressin)^61 (59, 91)38 (30, 52)0.02
BUN (Desmopressin given)70 (54, 120)56 (37, 78)0.16
Trainee11 (92%)88 (62%)0.04
Needle gauge 16 (vs. 18)10 (83%)78 (53%)0.04

*All risk factors with P<0.05 shown. ^Interaction P=0.008

Funding

  • NIDDK Support