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Kidney Biopsy-Related Complications in Hospitalized Patients with Acute Kidney Disease.


ABSTRACT:

Background and objectives

Patients are informed of the risk of kidney biopsy-related complications using data from nonhospitalized patients, which may underestimate the risk for hospitalized patients. We evaluated the rate and risk factors of kidney biopsy-related complications in hospitalized patients with acute kidney disease (AKD) to better estimate the risk in this population.

Design, setting, participants, & measurements

We used data from the Yale biopsy cohort to evaluate rates of kidney biopsy-related complications including adjudicated procedure-related bleeding requiring blood transfusions or angiographic interventions, medium- or large-sized hematomas, reimaging after biopsy including abdominal ultrasonography or computed tomography, and death in hospitalized patients with AKD (including AKI). We evaluated univariable and multivariable association of risk factors with transfusions. We compared rates of complications between hospitalized and nonhospitalized patients.

Results

Between 2015 and 2017, 159 hospitalized patients underwent a kidney biopsy for AKD evaluation, of which 80 (51%) had stage 1 AKI, 42 (27%) had stage 2 (or higher) AKI, and 27 (17%) had AKD (without AKI). Of these, 12 (8%; 95% confidence interval [95% CI], 5% to 15%) required a transfusion, three (2%; 95% CI, 1% to 5%) required an intervention, 11 (7%; 95% CI, 4% to 12%) had hematoma, and 31 (20%; 95% CI, 14% to 26%) required reimaging after biopsy. Of the four (3%; 95% CI, 1% to 6%) deaths during hospitalization, none were related to the biopsy. Female sex, lower platelet count, and higher BUN were associated with postbiopsy transfusions on univariable and multivariable analyses. Trainee as proceduralist and larger needle gauge were associated with transfusions in univariable, but not multivariable, analysis. Nonhospitalized patients had lower rates of transfusion than hospitalized patients, although the latter also had lower prebiopsy hemoglobin and greater surveillance after biopsy.

Conclusions

Hospitalized patients experience higher risk of postbiopsy complications than previously reported and several factors, such as lower platelet count, female sex, and higher BUN, are associated with this risk.

SUBMITTER: Moledina DG 

PROVIDER: S-EPMC6237071 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Kidney Biopsy-Related Complications in Hospitalized Patients with Acute Kidney Disease.

Moledina Dennis G DG   Luciano Randy L RL   Kukova Lidiya L   Chan Lili L   Saha Aparna A   Nadkarni Girish G   Alfano Sandra S   Wilson F Perry FP   Perazella Mark A MA   Parikh Chirag R CR  

Clinical journal of the American Society of Nephrology : CJASN 20181022 11


<h4>Background and objectives</h4>Patients are informed of the risk of kidney biopsy-related complications using data from nonhospitalized patients, which may underestimate the risk for hospitalized patients. We evaluated the rate and risk factors of kidney biopsy-related complications in hospitalized patients with acute kidney disease (AKD) to better estimate the risk in this population.<h4>Design, setting, participants, & measurements</h4>We used data from the Yale biopsy cohort to evaluate ra  ...[more]

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