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