Safety of Obtaining an Extra Biobank Kidney Biopsy Core
Abstract
1. Introduction
2. Material and Methods
2.1. Sample Selection
2.2. Clinical Variables
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics of Population
3.2. Post-Kidney Biopsy Complications
3.3. Risk Factors for Complications Associated with Kidney Biopsy
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Major Complications | Minor Complications |
---|---|
Need of transfusion | Pain |
Embolization | Hematuria |
Nephrectomy | Hematoma without blood transfusion |
Death |
Characteristics | All Patients |
---|---|
Patients (n) | 221 |
Age (years) | 56.6 (±16.8) |
Sex (Women/Men) (n, %) | 91 (41.2%)/130 (58.8%) |
Hypertension (>140/90 mmHg) (n, %) | 128 (57.9%) |
Diabetes Mellitus (n, %) | 52 (23.5%) |
Weight (kg) | 75.8 (±24.6) |
BMI (kg/m2) | 27.6 (±5.01) |
Systolic blood pressure (mmHg) | 136 (±24.6) |
Diastolic blood pressure (mmHg) | 76 (±15) |
Creatinine (mg/dL) | 2.24 (±1.94) |
Proteinuria (g/24 h) | 1.56 (0.506–3.59) |
Urinary albumin/creatinine ratio (mg/g) | 613 (100.3–2300) |
Urinary protein/creatinine ratio (mg/g) | 1153.8 (482.8–3156) |
Platelets (n) | 250.995 (±89.742) |
INR | 0.99 (±0.1) |
PT (seconds) | 11.86 (±1.2) |
Hb pre (g/dL) | 12.03 (±2.3) |
Hb post (g/dL) | 11.3 (±2.3) |
Microhematuria (n, %) | 100 (45.2%) |
Kidney size (cm) | 11.04 (±1.2) |
Cortical size (cm) | 1.67 (±0.64) |
Technique (US-guided/transjugular) (n, %) | 213 (96.4%)/8 (3.6%) |
Number of renal cores (n, %): | |
3 | 152 (68.8%) |
2 | 62 (28%) |
1 | 7 (3.2%) |
Anticoagulants (n, %): | |
Acenocoumarol | 7 (3.2%) |
Heparin | 3 (1.4%) |
Others | 5 (2.3%) |
Antiplatelets (n, %): | |
ASA 100 mg | 30 (13.6%) |
ASA 300 mg | 1 (0.5%) |
Clopidogrel | 5 (2.3%) |
Characteristics | Number of Kidney Cores | p | ||
---|---|---|---|---|
1 | 2 | 3 | ||
Patients (n, %) | 7 (3.2%) | 62 (28.1%) | 151 (68.8%) | - |
Age (years) | 45.4 (±17.9) | 56 (±17.2) | 57.4 (±16.5) | 0.171 |
Sex (Women/Men) (n, %) | 2 (28.6%)/ 5 (71.4%) | 29 (46.8%)/ 33 (53.2%) | 60 (39.5%)/ 92 (60.5%) | 0.486 |
Hypertension (n, %) | 5 (71.4%) | 37 (59.7%) | 86 (56.6%) | 0.699 |
Diabetes Mellitus (n, %) | 0 (0%) | 15 (24.2%) | 37 (24.3%) | 0.329 |
Weight (kg) | 68.3 (±19.2) | 74.8 (±15.3) | 76.6 (±15.3) | 0.321 |
BMI (kg/m2) | 25.4 (±2.8) | 27.1 (±5) | 27.9 (±5.1) | 0.298 |
Systolic blood pressure (mmHg) | 151.3 (±25.9) | 134.3 (±28.2) | 135.4 (±22.8) | 0.22 |
Diastolic blood pressure (mmHg) | 87.7 (±19.2) | 76.6 (±15.5) | 75.2 (±15) | 0.101 |
Creatinine (mg/dL) | 4.5 (±3.3) | 2.5 (±2.3) | 2 (±1.6) | 0.002 |
Proteinuria (g/24 h) | 2.8 [2.3–7.8] | 3 [2–4] | 2.8 [2.2–3.4] | 0.948 |
Urinary albumin/creatinine ratio (mg/g) | 387.4 [51.7–826.5] | 1577.2 [950–2204.4] | 1616 [1243–1989.1] | 0.403 |
Urinary protein/creatinine ratio (mg/g) | 131.1 [57.2–2005.1] | 2730.8 [1757.9–3703.6] | 2740.6 [2080.6–3400.7] | 0.619 |
Platelets (n) | 260,428 (±58,266) | 238,725 (±103,365) | 255,565 (±84,828) | 0.444 |
INR | 0.99 (±0.1) | 0.99 (±0.1) | 0.98 (±0.1) | 0.807 |
PT (seconds) | 11.9 (±1.2) | 11.9 (±1.1) | 11.8 (±1.2) | 0.843 |
Hb pre (g/dL) | 12.5 (±2.6) | 11.7 (±2.4) | 12.1 (±2.3) | 0.466 |
Hb post (g/dL) | 11.4 (±2.7) | 11.1 (±2.6) | 11.4 (±2.1) | 0.784 |
Microhematuria (n. %) | 4 (57.1%) | 26 (41.9%) | 70 (46.4%) | 0.689 |
Kidney size (cm) | 10.7 (±1.2) | 11.2 (±1.3) | 11 (±1.2) | 0.449 |
Cortical size (cm) | 1.7 (±0.2) | 1.7 (±0.3) | 1.7 (±0.3) | 0.985 |
Left kidney/Right kidney (n, %) | 3 (42.9%)/ 4 (57.1%) | 19 (31.1%)/ 42 (68.9%) | 77 (51%)/ 74 (49%) | 0.031 |
Technique (US-guided/ Transjugular) (n, %) | 7 (100%)/ 0 | 58 (93.5%)/ 4 (6.5%) | 148 (97.4%)/ 4 (2.6%) | 0.348 |
Transfusion (n, %) | 2 (28.6%) | 9 (14.5%) | 14 (9.2%) | 0.184 |
Anticoagulants (n. %): | ||||
Acenocoumarol | 0 | 3 (4.8%) | 4 (2.6%) | 0.701 |
Heparin | 0 | 1 (1.6%) | 2 (1.3%) | |
Others | 0 | 3 (4.8%) | 2 (1.3%) | |
Antiplatelets (n. %): | ||||
ASA 100 mg | 0 | 6 (9.7%) | 24 (15.8%) | |
ASA 300 mg | 0 | 0 | 1 (0.7%) | 0.743 |
Clopidogrel | 0 | 2 (3.2%) | 3 (2%) |
Characteristics | Without Complications | With Complications | p |
---|---|---|---|
Patients (n, %) | 183 (82.8%) | 38 (17.2%) | - |
Age (years) | 57.7 (±16.3) | 51.4 (±18.2) | 0.034 |
Sex (Women/Men) (n, %) | 73 (39.9%)/ 110 (40.1%) | 18 (47.4%)/ 20 (52.6%) | 0.469 |
Hypertension (n, %) | 108 (59%) | 20 (52.6%) | 0.476 |
Diabetes Mellitus (n, %) | 10 (26.3%) | 42 (23%) | 0.676 |
Weight (kg) | 76.9 (±15.4) | 70.5 (±14.5) | 0.022 |
BMI (kg/m2) | 27.8 (±4.97) | 26.2 (±5.1) | 0.096 |
Systolic blood pressure (mmHg) | 134.5 (±23.8) | 141 (±27.5) | 0.134 |
Diastolic blood pressure (mmHg) | 75.5 (±15.6) | 78.5 (±14.2) | 0.262 |
Creatinine (mg/dL) | 2.26 (±1.9) | 2.15 (±1.97) | 0.751 |
Proteinuria (g/24 h) | 2.85 (2.27–3.43] | 3.01 (1.88–4.15] | 0.809 |
Urinary albumin/creatinine ratio (mg/g) | 1556.57 (1214.84–1898.31] | 1622.96 (856.65–2389.27] | 0.875 |
Urinary protein/creatinine ratio (mg/g) | 2653.11 (2065.71–3240.52] | 2907.7 (1613.22–4202.19] | 0.725 |
Platelets (n) | 245,295 (±84,011) | 278,447 (±110,613) | 0.038 |
INR | 0.99 (±0.1) | 0.96 (0.09) | 0.07 |
PT (seconds) | 11.92 (±1.22) | 11.54 (±1.08) | 0.05 |
Hb pre (g/dL) | 12.07 (±2.27) | 11.84 (±2.56) | 0.057 |
Hb post (g/dL) | 11.4 (±2.2) | 10.8 (±2.5) | 0.14 |
Microhematuria (n, %) | 84 (46.2%) | 16 (42.1%) | 0.722 |
Kidney size (cm) | 11.08 (±1.25) | 10.84 (±1.09) | 0.277 |
Cortical size (cm) | 1.67 (±0.69) | 1.64 (±0.32) | 0.807 |
Left kidney/Right kidney (n, %) | 85 (47%)/ 96 (53%) | 24 (63.2%)/ 14 (36.8%) | 0.286 |
Technique (US-guided/transjugular) (n, %) | 177 (96.7%)/ 6 (3.3%) | 36 (94.7%)/ 2 (5.3%) | 0.628 |
Transfusion (n, %) | 15 (8.2%) | 10 (26.3%) | 0.003 |
Number of renal cores | |||
(n, %): | |||
3 | 130 (71%) | 22 (57.9%) | |
2 | 50 (27.3%) | 12 (31.6%) | 0.012 |
1 | 3 (1.6%) | 4 (10.5%) | |
Anticoagulants (n, %): | |||
Acenocoumarol | 7 (3.8%) | 0 | |
Heparin | 3 (1.6%) | 0 | 0.342 |
Others | 5 (2.7%) | 0 | |
Antiplatelets (n, %): | |||
AAS 100 mg | 24 (13.1%) | 6 (15.8%) | |
AAS 300 mg | 1 (0.5%) | 0 | 0.935 |
Clopidogrel | 4 (2.2%) | 1 (2.6%) |
Characteristics | Without Complications | Minor Complications | Major Complications | p |
---|---|---|---|---|
Patients (n, %) | 183 (82.8%) | 29 (13.1%) | 9 (4.1%) | - |
Age (years) | 57.7 (±16.3) | 52.9 (±17.8) | 46.6 (±20) | 0.065 |
Sex (Women/Men) (n, %) | 73 (39.9%)/ 110 (40.1%) | 13 (44.8%)/ 16 (55.2%) | 5 (55.6%)/ 4 (44.4%) | 0.591 |
Hypertension (n, %) | 108 (59%) | 17 (58.6%) | 3 (33.3%) | 0.312 |
Diabetes Mellitus (n, %) | 10 (26.3%) | 9 (31%) | 1 (11.1%) | 0.425 |
Weight (kg) | 76.9 (±15.4) | 71.04 (±14.4) | 68.97 (±15.3) | 0.069 |
BMI (kg/m2) | 27.8 (±4.97) | 26.93 (±5.36) | 24.13 (±3.73) | 0.097 |
Systolic blood pressure (mmHg) | 134.5 (±23.8) | 144.24 (±24.5) | 130.67 (±35.4) | 0.114 |
Diastolic blood pressure (mmHg) | 75.5 (±15.6) | 79.24 (±13.9) | 76.22 (±16) | 0.468 |
Creatinine (mg/dL) | 2.26 (±1.9) | 1.93 (±1.65) | 2.86 (±2.76) | 0.432 |
Proteinuria (g/24 h) | 2.85 (2.27–3.43) | 2.85 (1.57–4.2) | 3.47 (0.55–6.39) | 0.896 |
Urinary albumin/creatinine ratio (mg/g) | 1556.57 (1214.84–1898.31) | 1412.1 (789.6–2034.6) | 2255.6 (671.1–5182.3) | 0.632 |
Urinary protein/creatinine ratio (mg/g) | 2653.11 (2065.71–3240.52) | 2536.5 (1332–3741.02) | 4114.2 (536.9–8765.2) | 0.562 |
Platelets (n) | 245,295 (±84,011) | 270,517 (±80,529) | 304,000 (±181,464) | 0.072 |
INR | 0.99 (±0.1) | 0.94 (±0.07) | 1.02 (±0.11) | 0.028 |
PT (seconds) | 11.92 (±1.22) | 11.33 (±0.94) | 12.2 (±1.29) | 0.032 |
Hb pre (g/dL) | 12.07 (±2.27) | 12.26 (±2.67) | 10.49 (±1.64) | 0.115 |
Hb post (g/dL) | 11.4 (±2.2) | 11.28 (±2.45) | 9.24 (±2.13) | 0.02 |
Microhematuria (n, %) | 84 (46.2%) | 12 (41.4%) | 4 (44.4%) | 0.89 |
Kidney size (cm) | 11.08 (±1.25) | 10.93 (±1.1) | 10.57 (±1.1) | 0.413 |
Cortical size (cm) | 1.67 (±0.69) | 1.6 (±0.32) | 1.75 (±0.33) | 0.829 |
Left kidney/Right kidney (n, %) | 85 (47%)/ 96 (53%) | 10 (34.5%)/ 19 (65.5%) | 4 (44.4%)/ 5 (55.6%) | 0.455 |
Technique (US-guided/ Transjugular) (n, %) | 177 (96.7%)/ 6 (3.3%) | 29 (100%)/ 0 | 7 (77.8%)/ 2 (22.2%) | 0.006 |
Transfusion (n, %) | 15 (8.2%) | 5 (17.2%) | 5 (55.6%) | <0.001 |
Number of renal cores (n, %): | ||||
3 | 130 (71%) | 17 (58.6%) | 5 (55.6%) | |
2 | 50 (27.3%) | 9 (31%) | 3 (33.3%) | 0.064 |
1 | 3 (1.6%) | 3 (10.3%) | 1 (11.1%) | |
Anticoagulants (n. %): | ||||
Acenocoumarol | 7 (3.8%) | 0 | 0 | |
Heparin | 3 (1.6%) | 0 | 0 | 0.765 |
Others | 5 (2.7%) | 0 | 0 | |
Antiplatelets (n. %): | ||||
ASA 100 mg | 24 (13.1%) | 6 (20.7%) | 0 | |
ASA 300 mg | 1 (0.5%) | 0 | 0 | 0.378 |
Clopidogrel | 4 (2.2%) | 0 | 1 (11.1%) |
Variable | OR | CI (95%) | Lateral Significance (p) |
---|---|---|---|
PT (seconds) * | 1.36 | 0.94–1.97 | 0.1 |
Renal cores (1 core vs. 2/3 cores) | 7.09 | 1.34–37.04 | 0.021 |
Age (years) * | 1.01 | 0.99–1.04 | 0.299 |
Platelets (n) * | 1 | 1–1 | 0.130 |
Weight (kg) * | 1.02 | 0.99–1.04 | 0.245 |
Hb pre (g/dL) * | 1.13 | 0.94–1.36 | 0.2 |
Study | Country | Year | Type of Study | Number of Patients | Type of Needles | Number of Kidney Cores | Complications Regarding Number of Kidney Cores |
---|---|---|---|---|---|---|---|
Singh S, et al. [25] | United States | 2021 | Prospective | 20 | 18G (95%) 16G (5%) | From 2 to 6 cores (2.9) | No data |
Manno et al. [26] | Italy | 2011 | Randomized Clinical Trial | 162 | 16G | 2 cores | No data |
Peters et al. [27] | Sweden | 2018 | Prospective | 576 | 16G or 18G | From 2 to 3 cores (Unknown) | No differences |
Pombas et al. [12] | Spain | 2020 | Retrospective | 661 | 16G | 2 cores | No data |
Hogan et al. [28] | United States | 2020 | Prospective | 160 | 16G (54%) 18G (44%) | From 1 to 4 cores (Unknown) | No differences |
Leclerc et al. [29] | Canada | 2020 | Retrospective | 413 | 16G (98%) 18G (2%) | 2 cores (86%) 1 core (14%) | No data |
Sousanieh et al. [30] | United States | 2020 | Prospective | 592 | 14G (57%) 16G (43%) | From 1 to 3 cores (2.2–2.3) | No data |
Waldo et al. [31] | United States | 2009 | Prospective | 162 | 14G | No data | No data |
Pendon-Ruiz de Mier et al. [32] | Spain | 2014 | Prospective | 241 | 16G | From 1 to 2 cores (unknown) | No differences |
Li et al. [33] | China | 2018 | Retrospective | 551 | 16G or 18G (unknown) | From 1 to 4 cores (unknown) | No differences |
Lees et al. [34] | UK | 2017 | Retrospective | 2563 | 16G | From 1 to 3 cores (unknown) | No data |
Torres et al. [35] | Mexico | 2011 | Retrosepctive | 623 | 16G | No data | No data |
Current study | Spain | 2021 | Retrospective | 221 | 16G | 1 core (3.2%) 2 cores (28.1%) 3 cores (68.8%) | More complications in patients with one kidney core obtained. |
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Bermejo, S.; García-Carro, C.; Mast, R.; Vergara, A.; Agraz, I.; León, J.C.; Bolufer, M.; Gabaldon, M.-A.; Serón, D.; Bestard, O.; et al. Safety of Obtaining an Extra Biobank Kidney Biopsy Core. J. Clin. Med. 2022, 11, 1459. https://doi.org/10.3390/jcm11051459
Bermejo S, García-Carro C, Mast R, Vergara A, Agraz I, León JC, Bolufer M, Gabaldon M-A, Serón D, Bestard O, et al. Safety of Obtaining an Extra Biobank Kidney Biopsy Core. Journal of Clinical Medicine. 2022; 11(5):1459. https://doi.org/10.3390/jcm11051459
Chicago/Turabian StyleBermejo, Sheila, Clara García-Carro, Richard Mast, Ander Vergara, Irene Agraz, Juan Carlos León, Monica Bolufer, Maria-Alejandra Gabaldon, Daniel Serón, Oriol Bestard, and et al. 2022. "Safety of Obtaining an Extra Biobank Kidney Biopsy Core" Journal of Clinical Medicine 11, no. 5: 1459. https://doi.org/10.3390/jcm11051459
APA StyleBermejo, S., García-Carro, C., Mast, R., Vergara, A., Agraz, I., León, J. C., Bolufer, M., Gabaldon, M.-A., Serón, D., Bestard, O., & Soler, M. J. (2022). Safety of Obtaining an Extra Biobank Kidney Biopsy Core. Journal of Clinical Medicine, 11(5), 1459. https://doi.org/10.3390/jcm11051459