Medline ® Abstract for Reference 42

PURPOSE: To determine the effect of various risk factors on postbiopsy bleeding (PBB).

PROCEDURE: A retrospective review of 645 native kidney biopsies carried out from 1981 to 2001 was conducted. Data regarding age, gender, race, prebiopsy blood pressure, history of hypertension, pre- and postbiopsy haemoglobin/haematocrit, serum creatinine and blood urea nitrogen (BUN) were collected.

FINDINGS: The overall PBB complication rate was 6.2%. High blood pressure was associated with a high risk of bleeding (test for trend, P<0.05). It increased when systolic blood pressure (SBP) was>160 mm of Hg, diastolic blood pressure (DBP) was>100 mm of Hg, or mean arterial pressure (MAP) was>or = 120 mm of Hg. In patients with a history of hypertension, the risk of PBB was 3.74 times higher (P = 0.0001) than patients with no history of hypertension, irrespective of blood pressure at the time of biopsy. For patients with creatinine>2 mg/dL, the risk ratio for PBB was 5.89 when compared with patients with creatinine<or = 2 mg/dL. Logistic regression analysis showed that a history of hypertension was associated with PBB, with an odds ratio of 1.89 (confidence interval, 1.10-3.26, P<0.03), and serum creatinine of>2.0 mg/dL was associated with an odds ratio of 2.56 (confidence interval, 1.48-4.42, P = 0.001) for PBB.

CONCLUSIONS: The risk of PBB increases with high SBP, DBP or MAP. A history of hypertension and high serum creatinine are significant independent risk factors for PBB.