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Kidney Week

Abstract: SA-PO1113

QI Project: Identify Modifiable Risk Factors and Improve the Safety of Performing Kidney Biopsies

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Sasidharan, Sandeep Raja, SUNY Downstate Health Sciences University, New York City, New York, United States
  • Jatoi, Tahir Ahmed, SUNY Downstate Health Sciences University, New York City, New York, United States
  • Abushawer, Mohammad Waleed, SUNY Downstate Health Sciences University, New York City, New York, United States
  • Mahmoud, Yasmin N., SUNY Downstate Health Sciences University, New York City, New York, United States
  • Gruessner, Angelika C., SUNY Downstate Health Sciences University, New York City, New York, United States
  • Saggi, Subodh J., SUNY Downstate Health Sciences University, New York City, New York, United States
Background

Bleeding events are the most feared complication in patients undergoing kidney biopsies (KB). Certain factors have consistently shown to carry an increased risk such as CKD. Not assessed in all prior studies was whether KBs done under real-time CT vs ultrasound (USG) guidance or whether transplanted kidneys (TK) versus native kidneys (NK), or whether the use of automated trocar-guided biopsy guns (ATGBG) or the use of non-trocar guided biopsy guns (NTGBG) of various sizes carried any differential risk.

Methods

All KBs performed at our hospital between 2015 to 2022 were included. Two independent physicians reviewed the charts to acquire the data. Quantitative variables were presented as means +/- SDs using the Wilcoxon test, while qualitative variables as frequencies or %s and compared using the chi-square or Fisher's exact test. Only factors with p-value <0.3 were included for logistic regression.

Results

Overall, information on 174 biopsies performed was collected, of which native was 83% and 17% in a transplanted kidney. Blacks constituted 90% of cases. The median age was 42 Years [7-78 years]. Detailed descriptive results are in Table 1.
Univariate analysis showed bleeding risk statistically higher in >65 years and lower in CT-guided KB. In multivariable analysis, age was the most influential risk factor with every 5 years increased bleeding by 24%. Every 5-unit increase in BMI increased bleeding by 43% but not statistically. Fig 1

Conclusion

Our study found that additional safety measures needed to be considered when performing biopsies in the elderly. Using CT instead of USG guidance might be warranted for additional safety. We did not find any additional differential in risk of bleeding between NK versus TK or by the use of ATGBG versus NTGBG as far as some real time procedures were utilized.

Demographic
Total Biopsy 174Blacks 156 (90%)Native kidney 144 (83%)Transplant 30 (17%)Automated trocar 132 (76%)Non trocar guided 42% (24%)USG guide 144 (83%)CT guided 30 (17%)Median age 42 [7-78]Bleeding 17 (9.7%)

Multivariate analysis of bleeding