Arterial Stiffness is an Independent Risk Factor for Anemia After Percutaneous Native Kidney Biopsy

Tanaka, Keiko; Kitagawa, Masashi; Onishi, Akifumi; Yamanari, Toshio; Ogawa-Akiyama, Ayu; Mise, Kazuyuki; Inoué, Takao; Morinaga, Hiroshi; Uchida, Haruhito A.; Sugiyama, Hiroshi; Wada, Jun

doi:10.1159/000477453

Cited by 12 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another common complication of kidney biopsy was perinephric hematoma. Two studies were identified as influential for hematoma occurrence, each finding hematomas in over 80% of the cohort (9,10). Excluding these studies only decreased the proportion of hematomas from 11% to 8.8% (from one in nine to one in 11) and had little effect on study heterogeneity (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Native Kidney Biopsy Complications

Poggio

McClelland

Blank

et al. 2020

CJASN

145

101

View full text Add to dashboard Cite

Background and objectivesNative kidney biopsies are commonly performed in the diagnosis of acute kidney diseases and CKD. Because of the invasive nature of the procedure, bleeding-related complications are not uncommon. The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases–sponsored Kidney Precision Medicine Project requires that all participants undergo a kidney biopsy; therefore, the objective of this analysis was to study complication rates of native kidney biopsies performed using automated devices under kidney imaging.Design, setting, participants, & measurementsThis is a systematic review and meta-analysis of the literature published from January 1983 to March 2018. The initial PubMed search yielded 1139 manuscripts. Using predetermined selection criteria, 87 manuscripts were included in the final analysis. A random effects meta-analysis for proportions was used to obtain combined estimates of complication rates. Freeman–Tukey double-arcsine transformations were used to stabilize variance as complications were rare.ResultsA total of 118,064 biopsies were included in this study. Patient age ranged from 30 to 79 years, and 45% of patients were women. On the basis of our meta-analysis, pain at the site of biopsy is estimated to occur in 4.3% of biopsied patients, hematomas are estimated to occur in 11%, macroscopic hematuria is estimated to occur in 3.5%, bleeding requiring blood transfusions is estimated to occur in 1.6%, and interventions to stop bleeding are estimated to occur in only 0.3%. Death attributed to native kidney biopsy was a rare event, occurring only in an estimated 0.06% of all biopsies but only 0.03% of outpatient biopsies. Complication rates were higher in hospitalized patients and in those with acute kidney disease. The reported complications varied on the basis of study type and geographic location.ConclusionsAlthough the native kidney biopsy is an invasive diagnostic procedure, the rates of bleeding complications are low. Albeit rare, death can occur postbiopsy. Complications are more frequently seen after kidney biopsies of hospitalized patients with AKI.

show abstract

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Native Kidney Biopsy Complications

Poggio

McClelland

Blank

et al. 2020

CJASN

145

101

View full text Add to dashboard Cite

show abstract

“…Though usually safe, kidney biopsy can be associated with serious complications. The risk of minor bleeding episodes after PKB including self-limiting gross hematuria or small hematomas that did not need any blood transfusion or intervention is in the range of 17%-33% in a large meta-analysis of 9474 kidney biopsies, whereas major complications, including hemorrhage requiring transfusion, angiographic intervention, nephrectomy, or death, have been reported in only around 2%-8% of renal biopsies (5,6) Predictors of major bleeding are the presence of coagulopathy, kidney dysfunction (serum creatinine, >2.0 mg/dL), low concentration of hemoglobin, use of a wide needle, or atherosclerosis (7,8). The current data are from the only available study in the literature, on the issue of delayed onset bleed after PKB.…”

Section: Discussionmentioning

confidence: 99%

Delayed onset bleed after percutaneous kidney biopsy: is it the same as early bleed?

et al. 2021

View full text Add to dashboard Cite

Background While the majority of bleeding complications after a percutaneous kidney biopsy (PKB) occur early (≤24 h), delayed onset bleeding complications (>24 h) have been rarely reported and can be catastrophic for the patient. Purpose To describe the incidence, risk factors, and outcomes of delayed bleeding complications after PKB. Material and Methods We retrospectively studied native and graft kidney biopsies in patients who developed delayed bleeding complications (>24 h) after the biopsy performed in the Department of Nephrology and Renal Transplantation of a tertiary care medical institution in north India between January 2014 to December 2018. Results Of the 4912 renal biopsies reviewed, 20 patients (16 men, 4 women; 0.40%) had a delayed biopsy bleeding complication. Of these patients, 95% had major bleeding complications requiring blood transfusions and 85% needed intervention like gelfoam/coil embolization. Despite intervention, one patient (5%) had mortality due to complications of bleeding and sepsis. When compared to a control group of patients with early biopsy bleed, patients with the delayed biopsy bleed had similar demographic and clinical profiles except for higher pre-biopsy hemoglobin and lower systolic and diastolic blood pressure. Conclusion A post-PKB delayed onset bleed is not uncommon, and the vast majority of these patients had major bleeding complications requiring blood transfusions and/or intervention like embolization. They had a similar demographic and clinical profile presentation as early bleed patients. Meticulous outpatient monitoring and patient education after discharge may be useful to detect this complication promptly and to intervene early to have good patient outcome.

show abstract

“…Therefore, the absolute level of Hb decline (g/dL) after the renal biopsy was treated as the outcome, based on a previous study [ 20 ]. The relative level of Hb decline (%) and prevalence of Hb decline ≥10% were also investigated based on previous studies [ 21 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

Effect of Hemocoagulase on the Prevention of Bleeding after Percutaneous Renal Biopsy

Torigoe

Yamashita

Abe

et al. 2022

Toxins

View full text Add to dashboard Cite

A percutaneous renal biopsy is an essential tool for the diagnosis of various renal diseases; however, post-biopsy bleeding is a major complication. Hemocoagulase is a detoxified and purified snake venom enzyme that is widely used to prevent post-procedural bleeding. In this study, we retrospectively analyzed the effect of hemocoagulase on post-renal biopsy bleeding. We included 221 patients who underwent percutaneous renal biopsy between April 2017 and December 2020 and analyzed post-renal biopsy hemoglobin (Hb) decline in patients who were administered a periprocedural hemocoagulase injection. After the renal biopsy, the mean Hb decrease in the entire patient cohort was 0.33 ± 0.84 g/dL. Periprocedural hemocoagulase injection lowered the Hb decline post-renal biopsy (0.50 ± 0.87 vs. 0.23 ± 0.80 g/dL, p = 0.0204). The propensity-matched cohort was also adjusted for factors influencing postprocedural bleeding; periprocedural hemocoagulase injection reduced the Hb decline post-renal biopsy (0.56 ± 0.89 vs. 0.17 ± 0.74 g/dL, p = 0.006). There were no adverse events (e.g., thrombosis and anaphylactic shock) due to hemocoagulase. Our study demonstrated the beneficial effect of hemocoagulase on post-renal biopsy Hb decline, suggesting its clinical value in preventing post-renal biopsy bleeding.

show abstract

Arterial Stiffness is an Independent Risk Factor for Anemia After Percutaneous Native Kidney Biopsy

Cited by 12 publications

References 28 publications

Systematic Review and Meta-Analysis of Native Kidney Biopsy Complications

Systematic Review and Meta-Analysis of Native Kidney Biopsy Complications

Delayed onset bleed after percutaneous kidney biopsy: is it the same as early bleed?

Effect of Hemocoagulase on the Prevention of Bleeding after Percutaneous Renal Biopsy

Contact Info

Product

Resources

About