Abstract: PO0541
Risk Factors for Hemorrhage After Renal Biopsies: Analysis of Data from the National Inpatient Sample Database
Session Information
- CKD Clinical, Outcomes, and Trials - 1
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Zhang, Yi, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States
- Friedman, Harley, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States
Background
Prior studies examining risk factors associated with bleeding from renal biopsy have demonstrated conflicting results. The purpose of this study is to utilize the large sample size of the National Inpatient Sample (NIS) Database to explore risk factors associated with post procedure hemorrhage.
Methods
Data were gathered from the NIS Database (2012-2013). Records with a closed percutaneous needle biopsy of the kidney (procedure code 5523) were selected, excluding patients under age 18. Bleeding was defined by a diagnosis of hemorrhage/hematoma complicating a procedure (ICD-9 codes 99811, 99812). Binary logistic regression was performed to explore associations between hemorrhage and age, sex, and comorbidities defined in the NIS severity elements.
Results
The data set included 13260 renal biopsies, with 626 instances of bleeding related to procedure. The overall model fit was excellent (Χ2 = 119.6, p < 0.000). Seven comorbidities were significantly associated with bleeding. Obesity, age, hypertension were not significantly associated with bleeding.
Conclusion
Our results indicate that renal failure, female gender, coagulopathy, and anemia are risk factors for bleeding after renal biopsy, whereas obesity and hypertension are not. A strength of this study is the large sample size. It also suggests that peripheral vascular disease, collagen vascular disease, and weight loss increase bleeding risk. Limitations include lack of specific clinical details (e.g. creatinine levels) and risk for confounders. Also, though several individual risk factors were significant, the overall predictive value of the model was limited. In conclusion, this study supports previously thought of risk factors for hemorrhage after renal biopsy and introduces several factors that are of potential clinical significance.
Risk of Bleeding after Renal Biopsy By Comorbidity
| Relative Risk | Lower Limit CI | Upper Limit CI | p-value | Standard Error | |
| Chronic Blood Loss Anemia | 2.012 | 1.327 | 3.051 | .0010 | .212 |
| Renal Failure | 1.667 | 1.407 | 1.976 | .0000 | .087 |
| Coagulopathy | 1.600 | 1.289 | 1.986 | .0000 | .110 |
| Peripheral Vascular Disorders | 1.475 | 1.087 | 2.000 | .0124 | .155 |
| Rheumatoid Arthritis/Collagen Vascular Diseases | 1.415 | 1.063 | 1.883 | .0172 | .146 |
| Female Gender | 1.395 | 1.178 | 1.651 | .0001 | .086 |
| Weight Loss | 1.377 | 1.084 | 1.748 | .0087 | .122 |
| Hypertension | 1.086 | 0.920 | 1.282 | .3295 | .085 |
| Age | 0.998 | 0.993 | 1.003 | .4607 | .003 |
| Obesity | 0.844 | 0.664 | 1.072 | .1649 | .122 |