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Kidney Week

Abstract: TH-PO564

Safety and Adequacy of Kidney Biopsy Procedure in Patients With Obesity

Session Information

  • Pathology and Lab Medicine
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

  • 1700 Pathology and Lab Medicine

Authors

  • Qian, Long, Yale University, New Haven, Connecticut, United States
  • Weinstein, Jason Nathaniel, Yale University, New Haven, Connecticut, United States
  • Melchinger, Hannah Camille, Yale University, New Haven, Connecticut, United States
  • Hu, David G., Johns Hopkins University, Baltimore, Maryland, United States
  • Menez, Steven, Johns Hopkins University, Baltimore, Maryland, United States
  • Thiessen Philbrook, Heather, Johns Hopkins University, Baltimore, Maryland, United States
  • Luciano, Randy L., Yale University, New Haven, Connecticut, United States
  • Perazella, Mark A., Yale University, New Haven, Connecticut, United States
  • Shaw, Melissa M., Yale University, New Haven, Connecticut, United States
  • Parikh, Chirag R., Johns Hopkins University, Baltimore, Maryland, United States
  • Wilson, Francis Perry, Yale University, New Haven, Connecticut, United States
  • Moledina, Dennis G., Yale University, New Haven, Connecticut, United States
Background

Obesity is considered a risk factor for kidney biopsy-related complications. Here we compared the safety and adequacy of kidney biopsy procedures between obese and non-obese patients.

Methods

We included patients from the Yale kidney biopsy cohort enrolled between 2015-2017. Using linear regression analysis, we tested the association of class 2 obesity (body mass index ≥35kg/m2) with post-biopsy drop in hematocrit (hct) and number of glomeruli sampled, adjusting for pre-biopsy risk factors and needle gauge. We conducted a supplementary analysis using data from the Johns Hopkins University (JHU).

Results

Of the 337 patients at Yale, 76 (23%) had obesity. Obese patients were more likely to undergo biopsy using 18- (vs 16-) gauge needle (48 (66%) vs 113 (45%), P=0.002). Obese patients had a lesser drop in hct from pre- to post-biopsy in univariable analysis (2.1% vs 3.0%; unadjusted difference -0.95% (95% CI -0.14, -1.75); adjusted for pre-biopsy risk factors -0.92 (-1.73, -0.11)%]. Obesity was not associated with hct drop after further adjusting for needle gauge [-0.78 (-1.59, 0.03)%]. However, fewer glomeruli were sampled from obese patients [-2.6 (-4.6, -0.7) glomeruli]. At JHU (N=78, 12 obese), where all biopsies were performed using 18G needle, obesity was not associated with hct drop (0.40 (-1.26, 2.05)%). Meta-analysis of the two cohorts found no association of obesity with hct drop [-0.48 (-1.74, 0.78)%].

Conclusion

Obese patients did not have a greater risk of post-biopsy hematocrit drop than those without obesity but tended to have fewer glomeruli available for diagnosis. Future studies could examine techniques to improve diagnostic yield of kidney biopsy for obese patients.