Abstract: PUB310
Kidney Biopsy: Los Angeles General Medical Center Safety and Outcomes
Session Information
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- Min, Robert W. M., University of Southern California, Los Angeles, California, United States
- Mittal, Anuva, University of Southern California, Los Angeles, California, United States
- Lwin, May H, Los Angeles General Medical Center, Los Angeles, California, United States
Background
Renal biopsy is a minimally invasive procedure; however, bleeding can occur as a complication. This study focuses on native kidney biopsies performed at a major county hospital. Our goal is to review the safety of kidney biopsies and potential optimizations.
Methods
We conducted an 18-month retrospective review of data from 60 ultrasound-guided native kidney biopsies between January 2023 and June 2024. Age, sex, and comorbidities were controlled to assess the impact of biopsies on hemoglobin levels. T-tests and spearman correlation were performed to evaluate statistical significance.
Results
We reviewed 60 patients, 29 females and 31 males. Aged 18 to 71, average age of 42 years (± 13) for men and 44 years (± 15) for women. 11 females and 9 males had either diabetes or hypertension, while 7 females and 11 males had both.16 patients had known SLE. Other reasons for biopsy included nephrotic and nephritic presentations.
We reviewed 23 targeted and 37 non-targeted renal biopsies. NSAIDs and aspirin were withheld for 7 days prior to the renal biopsy. The baseline eGFR was below 60 in 50 patients, while 10 patients had an eGFR above 60. Pre-biopsy blood urea nitrogen (BUN) levels were below 20 in 21 patients, and above 20 in 39 patients.
Statistical analysis indicated that drops in hemoglobin after biopsy were significantly associated with BUN levels higher than 20, regardless of sex. Pre-biopsy platelet count, the sizes of the biopsy needles, and the number of passes did not show any statistically significant difference in hemoglobin drops across pre-biopsy, 1 hour post biopsy, and 24 hours after biopsy. No major complications were reported including blood transfusions, perinephric hematomas, gross hematuria, or infections.
Conclusion
Uremic bleeding is a significant consideration in post biopsy monitoring. This finding is consistent with other literature regarding renal biopsy complications. Use of DDAVP/ desmopressin to prevent uremic bleeding in patients with high BUN burden can be considered when appropriate. More periprocedural optimization is warranted to improve lengths of stay and outcomes.