Risk factors for bleeding complications after nephrologist-performed native renal biopsy

Lees, J. S. , McQuarrie, E. P., Mordi, N., Geddes, C. C., Fox, J. G. and Mackinnon, B. (2017) Risk factors for bleeding complications after nephrologist-performed native renal biopsy. Clinical Kidney Journal, 10(4), pp. 573-577. (doi: 10.1093/ckj/sfx012) (PMID:28852497) (PMCID:PMC5570080)

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Background: Bleeding is a recognized complication of native percutaneous renal biopsy. This study aimed to describe the incidence of major bleeding after biopsy in a single centre over a 15-year period and examine factors associated with major bleeding. Methods: We identified consecutive adult patients undergoing ultrasound-guided native renal biopsy in the Glasgow Renal and Transplant Unit from 2000 to 2014. From the electronic patient record, we collected data pertaining to biopsy indication, pre- and post-biopsy laboratory measurements, prescribed medication and diagnosis. Aspirin was routinely continued. We defined major bleeding post-biopsy as the need for blood transfusion, surgical or radiological intervention or death. Binary logistic regression analysis was used to assess factors associated with increased risk of major bleeding. Results: There were 2563 patients who underwent native renal biopsy (1499 elective, 1064 emergency). The average age of patients was 57 (SD 17) years and 57.4% were male. Overall, the rate of major bleeding was 2.2%. In all, 46 patients required transfusion (1.8%), 9 patients underwent embolization (0.4%), no patient required nephrectomy and 1 patient died as a result of a significant late retroperitoneal bleed. Major bleeding was more common in those undergoing emergency compared with elective renal biopsy (3.4 versus 1.1%; P < 0.001). Aspirin was being taken at the time of biopsy in 327 of 1509 patients, with no significant increase in the risk of major bleeding (P = 0.93). Body mass index (BMI) data were available for 546 patients, with no increased risk of major bleeding in 207 patients classified as obese (BMI >30). Conclusions: The risk of major bleeding following native renal biopsy in the modern era is low. Complications are more common when biopsy is conducted as an emergency, which has implications for obtaining informed consent. Our data support the strategy of not stopping aspirin before renal biopsy.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Fox, Dr Jonathan and McQuarrie, Dr Emily and Mackinnon, Dr Bruce and Lees, Jennifer
Authors: Lees, J. S., McQuarrie, E. P., Mordi, N., Geddes, C. C., Fox, J. G., and Mackinnon, B.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Clinical Kidney Journal
Publisher:Oxford University Press
ISSN (Online):2048-8513
Published Online:15 March 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Clinical Kidney Journal 10(4):573-577
Publisher Policy:Reproduced under a Creative Commons License

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