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Abstract: SA-PO635

Percutaneous Native Kidney Biopsy in Obese Patients: Feasibility and Histological Findings

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Santa Catharina, Guilherme P., University of Sao Paulo (USP), Sao Paulo, Brazil
  • Smolentzov, Igor, University of Sao Paulo (USP), Sao Paulo, Brazil
  • Dias, Cristiane B., University of Sao Paulo (USP), Sao Paulo, Brazil
  • Yu, Luis, University of Sao Paulo (USP), Sao Paulo, Brazil
  • Woronik, Viktoria, University of Sao Paulo (USP), Sao Paulo, Brazil
  • Zatz, Roberto, University of Sao Paulo (USP), Sao Paulo, Brazil
  • Jorge, Lectícia, University of Sao Paulo (USP), Sao Paulo, Brazil
Background

Body Mass Index (BMI) > 30 kg/m2 is an independent risk factor for proteinuria and Chronic Kidney Disease. There are few studies on kidney biopsy of obese patients (OP). This study assessed the results of renal biopsies and their complications in this group as compared to nonobese patients (NOP).

Methods

This is a retrospective cohort study of native kidney biopsies performed between January/2009 and December/2018 at a tertiary university center. Clinical and laboratory data were collected at the time of the procedure. Biopsy indication, sample quality, procedural complications and histological diagnoses were analyzed, comparing OP and NOP.

Results

A total of 171 biopsies were performed in OP (mean BMI 33.1±2.8 kg/m2) and 780 in NOP (mean BMI 23.8±3 kg/m2). When compared to NOP, we found a higher proportion of women (68% x 60%, p=0.04) and higher age (45±14 x 39±16, p<0.001) in OP. The indications for biopsy did not differ significantly between groups.
Although a higher number of OP required more than 3 needle shots (23% x 12%, p=0.0002), the representativeness of samples did not differ between groups: an average of 17±9 glomeruli for light microscopy and 11±8 for immunofluorescence was obtained in OP, compared to 18±9 and 11±8 in NOP (p>0.05). The incidence of complications such as hematuria (6% x 7%), need for arteriography (1% x 2%) and blood transfusion (2% x 3%) was also similar in OP and NOP (p>0.05).
The most common histological diagnoses in OP were Lupus Nephritis (LN, n=42, 25%); Focal Segmental Glomerulosclerosis (FSGS, n=33, 19%); Membranous Glomerulopathy (MG, n=20, 12%); Diabetic Nephropathy (n=13, 8%) and IgA Nephropathy (IgAN, n=13, 8%), whereas in NOP LN (n=128, 16%); FSGS (n=79, 10%); MG (n=45, 6%) and IgAN (n=34, 4%) were the main diagnoses.

Conclusion

Kidney biopsy of obese patients is safe, feasible and effective. In our cohort, despite the need for more needle shots, the representativeness of samples and the rate of complications were similar between OP and NOP. Of note, FSGS was not the most frequent histologic finding. A broad spectrum of patterns was observed, implying equally variable therapeutic schemes and reinforcing the appropriateness of performing renal biopsies in this particular group of patients.