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Kidney Week

Abstract: PO2291

Association Between Diabetes and Major Bleeding Complications of Renal Biopsy: Analysis of 76,304 Patients Using a National Inpatient Database in Japan

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Hasegawa, Sho, Tokyo Daigaku, Bunkyo-ku, Tokyo, Japan
  • Okada, Akira, Tokyo Daigaku, Bunkyo-ku, Tokyo, Japan
  • Nangaku, Masaomi, Tokyo Daigaku, Bunkyo-ku, Tokyo, Japan
Background

Nephrologists have recently recognized the heterogeneity of kidney diseases in patients with diabetes and actively performed percutaneous renal biopsies (PRBs). However, the association between diabetes and major bleeding complications of PRBs remains unclear.

Methods

In this retrospective observational study using the Japanese nationwide Diagnosis Procedure Combination inpatient database, we identified patients who underwent an elective PRB between July 2010 and March 2018. The primary outcome was the occurrence of major bleeding complications defined as (i) red blood cell transfusion within 7 days after the PRB or (ii) invasive hemostasis after the PRB. Multiple regression analysis was performed to analyze the association between diabetes and major bleeding complications with adjustment for patient and hospital characteristics.

Results

We identified 76,304 patients, including 8,245 patients with diabetes. The proportion of biopsies for patients with diabetes to total biopsies increased year by year (Figure 1). Major bleeding complications occurred in 678 (0.9%) patients, including 622 (0.8%) red blood cell transfusion and 109 (0.1%) invasive hemostasis. Diabetes was significantly associated with major bleeding complications (RR, 2.66; 95% CI, 2.12-3.34) after adjusted for patient and hospital characteristics. Among patients with diabetes, multi-agent or insulin treatment showed a significant association with major bleeding complications (RR, 1.55; 95% CI, 1.16-2.08), compared with single-agent diabetes treatment.

Conclusion

Diabetes was an independent risk factor for major bleeding complications of PRBs. Moreover, severity of diabetes was associated with increase in major bleeding complications. Nephrologists should carefully judge whether the anticipated benefits counterbalance the relatively high risk of major bleeding complications when considering PRBs for patients with diabetes.

Funding

  • Government Support – Non-U.S.