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Kidney Week

Abstract: PO0541

Risk Factors for Hemorrhage After Renal Biopsies: Analysis of Data from the National Inpatient Sample Database

Session Information

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 RiskLower Limit CIUpper Limit CIp-valueStandard Error
Chronic Blood Loss Anemia2.0121.3273.051.0010.212
Renal Failure1.6671.4071.976.0000.087
Coagulopathy1.6001.2891.986.0000.110
Peripheral Vascular Disorders1.4751.0872.000.0124.155
Rheumatoid Arthritis/Collagen Vascular Diseases1.4151.0631.883.0172.146
Female Gender1.3951.1781.651.0001.086
Weight Loss1.3771.0841.748.0087.122
Hypertension1.0860.9201.282.3295.085
Age0.9980.9931.003.4607.003
Obesity0.8440.6641.072.1649.122