Percutaneous Kidney Biopsy and the Utilization of Blood Transfusion and Renal Angiography Among Hospitalized Adults
Percutaneous Kidney Biopsy and the Utilization of Blood Transfusion and Renal Angiography Among Hospitalized Adults
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DOI：
10.1016/j.ekir.2019.07.008
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发表时间：
2019-10-01
影响因子：
6
通讯作者：
Kambham, Neeraja
中科院分区：
文献类型：
--
作者：
Charu, Vivek;O'Shaughnessy, Michelle M.;Kambham, Neeraja
简介：有关住院患者经皮肾活检 (KBx) 发生率和出血并发症频率的数据有限。方法：使用具有全国代表性的美国住院出院数据，我们报告了 2007 年至 2014 年住院患者 KBx 发生率的时间趋势，并估计了浓缩红细胞 (pRBC) 输注和肾活检的频率和危险因素。 结果：从 2007 年到 2014 年，成年住院患者的天然 KBx 比率从每 10 万人中 8.2 例增加到 10.0 例，而移植 KBx 率从每 10 万人中 3.6 例下降到 3.1 例。我们研究了 35,183 和 14,266 条自然和移植 KBx 的出院记录。我们发现，5.7%（95%置信区间 [CI]：5.3%-6.0%）接受天然 KBx 的住院患者和 4.9%（4.2%-5.5%）接受移植 KBx 的住院患者在活检后 2 天内接受了 pRBC 输注。同样，0.6%（0.5%-0.7%）接受天然 KBx 的住院患者和 0.4%（0.2%-0.5%）接受移植 KBx 的住院患者在 KBx 后 2 天内接受了肾血管造影。对于住院天然 KBx 患者，女性、年龄较大、慢性肾病分期较高、急性肾功能衰竭、狼疮、血管炎、肝硬化、多发性骨髓瘤/副蛋白血症和慢性病贫血与 pRBC 输注几率增加独立相关；肝硬化和终末期肾病 (ESRD) 与肾血管造影的几率增加相关，肾病综合征与肾血管造影的几率降低相关。结论：在这项基于住院患者 KBx 实践的大型人群研究中，我们证明了美国成年人中住院患者天然 KBx 的比例不断增加，并准确估计了 pRBC 输注和肾血管造影的频率和危险因素 住院 KBx 后。
Introduction: Data on percutaneous kidney biopsy (KBx) incidence and frequencies of hemorrhagic complications among inpatients are limited.Methods: Using nationally representative US hospitalization discharge data, we report temporal trends in inpatient KBx rates from 2007 to 2014 and estimate frequencies of, and risk factors for, utilization of packed red blood cell (pRBC) transfusion and renal angiography.Results: From 2007 to 2014, rates of native KBx among adult inpatients increased from 8.2 to 10.0 per 100,000, while transplant KBx rates declined from 3.6 to 3.1 per 100,000. We studied 35,183 and 14,266 discharge records with native and transplant KBx. We found that 5.7% (95% confidence interval [CI]: 5.3%-6.0%) of inpatients undergoing native KBx and 4.9% (4.2%-5.5%) of those undergoing transplant KBx received a pRBC transfusion within 2 days of biopsy. Similarly, 0.6% (0.5%-0.7%) of inpatients undergoing native KBx and 0.4% (0.2%-0.5%) undergoing transplant KBx received a renal angiogram within 2 days of KBx. For inpatient native KBx, female sex, older age, higher chronic kidney disease stage, acute renal failure, lupus, vasculitis, cirrhosis, multiple myeloma/paraproteinemia, and anemia of chronic disease were independently associated with increased odds of pRBC transfusion; cirrhosis and end-stage renal disease (ESRD) were associated with increased odds, and nephrotic syndrome was associated with decreased odds, of renal angiography.Conclusions: In this large population-based study of inpatient KBx practices, we demonstrate increasing rates of inpatient native KBx among US adults and provide accurate estimates of the frequencies of, and risk factors for, pRBC transfusion and renal angiography following inpatient KBx.