Incidence and Risk Factors of Post-Biopsy Hemorrhage Following Percutaneous Renal Biopsy: A Two-Year Retrospective Study from a Tertiary Hospital in Southeast China

 

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Incidence and Risk Factors of Post-Biopsy Hemorrhage Following Percutaneous Renal Biopsy: A Two-Year Retrospective Study from a Tertiary Hospital in Southeast China

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Zishan
Lin
Zishan Lin linzishan1993@163.com the First Affiliated Hospital, Fujian Medical University Nephrology Fuzhou China *
Shidong Xie 2537305050@qq.com the First Affiliated Hospital, Fujian Medical University Nephrology Fuzhou China -
Wenfeng Wang greyxk@foxmail.com the First Affiliated Hospital, Fujian Medical University Nephrology Fuzhou China -
Yanfang Xu xuyanfang99@hotmail.com the First Affiliated Hospital, Fujian Medical University Nephrology Fuzhou China -
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Percutaneous renal biopsy (PRB) is essential for the diagnosis, prognosis, and management of various kidney diseases. Bleeding is the most common complication associated with PRB. Although its incidence has markedly decreased with advances in technology, the risk remains clinically relevant. Balancing procedural success with minimizing bleeding complications remains an important challenge in nephrology practice.

This two-year retrospective study included 679 patients who underwent PRB between January 2022 and December 2023 at a tertiary hospital in southeast China. Continuous variables were analyzed using the Mann–Whitney test, while categorical variables were compared using the chi-square or Fisher’s exact test. Multivariate logistic regression analysis was applied to identify independent risk factors associated with post-biopsy hemorrhage.

Among 679 patients, post-biopsy bleeding occurred in 8.84% (60/679) of cases. A hemoglobin drop ≥20 g/L within 48 hours was observed in 4.86% (33/679), perirenal hematoma >5 cm requiring hemostatic medication in 4.27% (29/679), blood transfusion in 1.03% (7/679), and transcatheter embolization in 0.59% (4/679). Post-biopsy shock and mortality each occurred in 0.59% (4/679) and 0.29% (2/679), respectively. The incidence of bleeding varied across pathological subtypes, being highest in ANCA-associated vasculitis (12.00%), followed by diabetic nephropathy (10.34%), membranous nephropathy (10.00%), lupus nephritis (9.88%), and minimal change disease (8.33%). Multivariate analysis identified prolonged prothrombin time (PT) as an independent predictor of post-biopsy hemorrhage (OR = 2.326, 95% CI = 1.251–4.326).

The incidence of bleeding following PRB was 8.84% in this two-year cohort. Prolonged PT was significantly associated with an increased risk of post-biopsy hemorrhage. These findings highlight the importance of careful pre-procedural management, including discontinuation of anticoagulant or antiplatelet agents, routine monitoring of blood counts and coagulation profiles, and comprehensive risk assessment to minimize post-biopsy bleeding complications.


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