Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Dec 25, 2023; 12(5): 147-158
Published online Dec 25, 2023. doi: 10.5527/wjn.v12.i5.147
Bleeding complications after percutaneous kidney biopsies – nationwide experience from Brunei Darussalam
Chiao Yuen Lim, Sai Laung Khay
Chiao Yuen Lim, Sai Laung Khay, Department of Renal Services, RIPAS Hospital, Bandar Seri Begawan BA1712, Brunei Darussalam
Author contributions: Lim CY designed the research, contributed to the statistical analysis, literature review, writing and revision; Khay SL collected the data and contributed to the writing and revision; all authors approved the paper.
Institutional review board statement: This study has been approved by the Medical and Health Research and Ethics Committee, Ministry of Health, Brunei Darussalam. The reference number is MHREC/MOH/2023/1(1).
Conflict-of-interest statement: The authors have nothing to disclose.
Data sharing statement: All data is included in the manuscript and/or supporting information. The data supporting this study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE statement – checklist of items, and the manuscript was prepared and revised according to the STROBE statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chiao Yuen Lim, FASN, FRCP, MBChB, MMed, MRCP, Consultant Physician-Scientist, Department of Renal Services, RIPAS Hospital, Jalan Putera Al-Muhtadee Billah, Bandar Seri Begawan BA1712, Brunei Darussalam. chiaoyuenlim905@gmail.com
Received: July 20, 2023
Peer-review started: July 20, 2023
First decision: September 4, 2023
Revised: September 11, 2023
Accepted: September 27, 2023
Article in press: September 27, 2023
Published online: December 25, 2023
Processing time: 155 Days and 8.5 Hours
ARTICLE HIGHLIGHTS
Research background

Kidney biopsy serves as a valuable method for both diagnosing and monitoring kidney conditions. However, various studies have identified several risk factors associated with bleeding complications following the procedure, but these findings have shown inconsistency and variation.

Research motivation

Identifying key factors that significantly predict complications following a kidney biopsy is valuable in providing patients with essential information when seeking their consent for the procedure.

Research objectives

Our primary objective was 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.

Research methods

We performed a retrospective review of records of patients who underwent percutaneous kidney biopsies in Brunei Darussalam from October 1, 2013 to September 30, 2020. The demographic, clinical, laboratory and procedural-related characteristics of the patients were reviewed.

Research results

A total of 255 kidney biopsies were included. The incidence of bleeding (including hematuria and perinephric hematoma) stood at 6.3%. Blood transfusions were deemed necessary for 2.8% of patients, and fortunately, no patient suffered kidney loss or mortality due to the biopsy procedure. In a multivariable logistic regression analysis, two factors emerged as independent risk contributors for post-biopsy bleeding: baseline hemoglobin levels and the presence of microscopic hematuria. Additionally, a lower baseline platelet count emerged as the primary risk factor associated with the need for post-biopsy transfusions.

Research conclusions

Our findings align with existing research regarding the predictive risk factors for post-kidney biopsy bleeding complications. Nevertheless, our study uniquely highlights that the presence of pre-biopsy microscopic hematuria represents a notable and previously unreported risk factor for these complications.

Research perspectives

While our findings support the safety of kidney biopsy, it is important to carefully evaluate patients in order to minimize the risks associated with the procedure.