Bleeding complications after percutaneous kidney biopsies–nationwide experience from Brunei Darussalam  

作　　者：Chiao Yuen Lim Sai Laung Khay 

机构地区：[1]Department of Renal Services,RIPAS Hospital,Bandar Seri Begawan BA1712,Brunei Darussalam

出　　处：《World Journal of Nephrology》2023年第5期147-158,共12页世界肾病学杂志（英文版）

摘　　要：BACKGROUND Kidney biopsy serves as a valuable method for both diagnosing and monitoring kidney conditions.Various studies have identified several risk factors associated with bleeding complications following the procedure,but these findings have shown inconsistency and variation.AIM To investigate the risk of bleeding complications following percutaneous kidney biopsy in Brunei Darussalam.We sought to explore the relevant clinical and pathological risk factors associated with these complications while also considering the findings within the broader international literature context.METHODS We conducted a retrospective study of all adult patients who underwent kidney biopsy in Brunei Darussalam from October 2013 to September 2020.The outcomes of interest were post-biopsy bleeding and the need for blood transfusions.Demographics,clinical,laboratory and procedural-related data were collected.Logistic regression analysis was used to identify predictors of outcomes.RESULTS A total of 255 kidney biopsies were included,with 11%being performed on transplanted kidneys.The majority of biopsies were done under ultrasound guidance(83.1%),with the rest under computer tomography guidance(16.9%).The most common indications for biopsy were chronic kidney disease of undefined cause(36.1%),nephrotic syndrome(24.3%)and acute kidney injury(11%).Rate of bleeding complication was 6.3%–2%frank hematuria and 4.3%perinephric hematoma.Blood transfusion was required in 2.8%of patients.No patient lost a kidney or died because of the biopsy.Multivariate logistic regression identified baseline hemoglobin[odds ratio(OR):4.11;95%confidence interval(95%CI):1.12-15.1;P=0.03 for hemoglobin≤11 g/dL vs.>11 g/dL)and the presence of microscopic hematuria(OR:5.24;95%CI:1.43-19.1;P=0.01)as independent risk factors for post-biopsy bleeding.Furthermore,low baseline platelet count was identified as the dominant risk factor for requiring postbiopsy transfusions.Specifically,each 10109/L decrease in baseline platelet count was associated with an 12%incre

关 键 词：Kidney biopsy Bleeding complications Logistic regression Retrospective cohort study RISK 

分 类 号：R69[医药卫生—泌尿科学]