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Clinical risk factors associated with bleeding after native kidney biopsy
Author(s) -
SHIDHAM GANESH B,
SIDDIQI NAUMAN,
BERES JOSEPH A,
LOGAN BRENT,
NAGARAJA HN,
SHIDHAM SHUBHANGI G,
PIERING WALTER F
Publication year - 2005
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2005.00394.x
Subject(s) - medicine , blood pressure , odds ratio , creatinine , confidence interval , blood urea nitrogen , risk factor , renal function , gastroenterology , urology , surgery
SUMMARY: Purpose: To determine the effect of various risk factors on postbiopsy bleeding (PBB). Procedure: A retrospective review of 645 native kidney biopsies carried out from 1981 to 2001 was conducted. Data regarding age, gender, race, prebiopsy blood pressure, history of hypertension, pre‐ and postbiopsy haemoglobin/haematocrit, serum creatinine and blood urea nitrogen (BUN) were collected. Findings: The overall PBB complication rate was 6.2%. High blood pressure was associated with a high risk of bleeding (test for trend, P < 0.05). It increased when systolic blood pressure (SBP) was >160 mm of Hg, diastolic blood pressure (DBP) was >100 mm of Hg, or mean arterial pressure (MAP) was ≥120 mm of Hg. In patients with a history of hypertension, the risk of PBB was 3.74 times higher ( P = 0.0001) than patients with no history of hypertension, irrespective of blood pressure at the time of biopsy. For patients with creatinine >2 mg/dL, the risk ratio for PBB was 5.89 when compared with patients with creatinine ≤2 mg/dL. Logistic regression analysis showed that a history of hypertension was associated with PBB, with an odds ratio of 1.89 (confidence interval, 1.10–3.26, P < 0.03), and serum creatinine of >2.0 mg/dL was associated with an odds ratio of 2.56 (confidence interval, 1.48–4.42, P = 0.001) for PBB. Conclusions: The risk of PBB increases with high SBP, DBP or MAP. A history of hypertension and high serum creatinine are significant independent risk factors for PBB.