Abstract: SA-PO630
Risk Factors for Biopsy Complications in Initial vs. Subsequent Biopsies in Native and Transplant Kidneys
Session Information
- Glomerular Diseases: ANCA, Anti-GBM, Kidney Biopsy
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Peters, Björn, Skaraborg Hospital, Skövde, Sweden
- Maitlo, Salar abbas, Skaraborg Hospital, Skövde, Sweden
- Hadimeri, Henrik, Skaraborg Hospital, Skövde, Sweden
Background
There are few studies about risk factors for complications in initial (ib) versus subsequent (sb) biopsies. Biopsy complications are divided in major (require an intervention) and minor (resolve without intervention). The aim of the study was to explore the risk factors for complications in ib versus sb in native (nkb) and transplant kidney biopsies (tkb) which may serve as predictors for biopsy complications.
Methods
In a multi-center study, 2830 nkb (4.3% sb) were analyzed for major and 667 tkb (29% sb) for major and minor complications. No death or nephrectomy was described. Fisher’s exact, t-test (mean values) and χ2 test were used. A two sided p-value <0.05 was considered significant.
Results
In nkb, the frequency for major biopsy complications was 5.6% in ib and 4.9% in sb. In tkb, the biopsy complication frequency was 4% major and 2.3% minor in ib; in sb 3.5% major and 3.5% minor. In initial nkb, the frequency of major complications were higher in women compared to men (7.1% vs 4.6%;Odds Ratio 1.6,Confidence Interval 1.1-2.2), in younger patients (50 vs 54years,p=0.007) and in patients with lower weight (78 vs 82kg,p=0.005). In subsequent nkb, patients with major complications had a higher systolic blood pressure (145 vs 132mmHg,p=0.03). In initial tkb, biopsies with major complications had less glomeruli in the biopsy (17 vs 24,p=0.046) and biopsies with minor complications were from younger patients (42.5 vs 52years,p=0.027) and patients with lower BMI (22 vs 26,p=0.049). Risk factors for overall complications in initial txb were younger age (46 vs 52years,p=0.028) and less glomeruli in the biopsies (18 vs 24,p=0.04). In subsequent tkb, patients with major complications had a higher systolic (151 vs 136mmHg,p=0.03) and diastolic blood pressure (93 vs 79mmHg,p=0.003). For minor and overall complications in subsequent nkb, no risk factors were found. In nkb, in sb there was a higher number of SLE-nephritis (12% vs 4.6%,p=0.001), a lower number of nephrosclerosis (4.3% vs 10.3%,p=0.02) and diabetic nephropathy (3.4% vs 9.3%,p=0.02) compared to ib; in tkb no differences were found.
Conclusion
The different types of risk factors for biopsy complications in initial versus subsequent biopsies in native and transplant kidneys could be important for the clinicians to improve patients` safety.