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Abstract: SA-PO685

Feasibility and Safety of Obtaining Kidney Biopsy Research Cores in a Predominantly Black Lupus Nephritis Patient Population

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Authors

  • Cobb, Jason, Emory University School of Medicine, Atlanta, Georgia, United States
  • Farris, Alton Brad, Emory University School of Medicine, Atlanta, Georgia, United States
  • Akhgar, Ahmad, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Illei, Gabor G., AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Sinibaldi, Dominic P., AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • White, Wendy I., AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Lim, S. Sam, Emory University School of Medicine, Atlanta, Georgia, United States
Background

Lupus nephritis (LN) occurs in >50% of patients with SLE. Black patients disproportionately suffer from LN with more severe disease. Histologic examination of kidney tissue is required for definitive diagnosis and advancing the science. We are reporting the feasibility and safety of obtaining kidney biopsy research cores in a high-risk group of LN patients as part of a study that was carried out to detect novel biomarkers associated with LN.

Methods

Patients suspected of having LN were referred for a diagnostic kidney biopsy, and all had estimated proteinuria >500 mg/g. Patients consented to an extra pass for the obtainment of a research core. Kidney biopsies were performed at three hospitals: Emory University Hospital, Emory University Hospital Midtown, and Grady Memorial Hospital.

Results

A total of 47 patients suspected of LN were enrolled from 2014-2017. All patients underwent at least 3 core passes using standard 16 cm, 18 gauge biopsy needles by interventional radiologists (CT guided) or nephrology services (ultrasound guided). A total of 46 LN patients had a kidney biopsy and 40 patients had sufficient research core samples. Standard of care for CT guided kidney biopsy is same-day hospital discharge and an overnight stay after an ultrasound guided biopsy. Patients were 82% female and 90% Black race. The mean systolic blood pressure was 135 ± 17 mmHg. The mean hemoglobin was 10±1.8 g/dL and mean platelet count 219±94 103/mcL. Only one LN patient had an adverse outcome requiring hospital admission after a CT guided biopsy and that patient required renal artery embolization but did not receive a blood transfusion.

Conclusion

We demonstrated that the obtainment of research core samples in addition to the usual cores needed for a diagnostic kidney biopsy is feasible and overall safe with only 1 patient requiring an unplanned hospital admission. Suspected LN patients were generally agreeable to an extra pass for research purposes, particularly notable in this sample of mostly Black patients. The obtainment of research kidney biopsy cores is a newer discussion topic in nephrology, and this study is even more unique since it was successfully carried out in SLE patients which are likely at higher risk of bleeding due to higher rates of thrombocytopenia and anemia.

Funding

  • Commercial Support – AstraZeneca