Arterial Stiffness is an Independent Risk Factor for Anemia After Percutaneous Native Kidney Biopsy
Arterial Stiffness is an Independent Risk Factor for Anemia After Percutaneous Native Kidney Biopsy
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DOI：
10.1159/000477453
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发表时间：
2017-01-01
影响因子：
2.8
通讯作者：
Wada, Jun
中科院分区：
文献类型：
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作者：
Tanaka, Keiko;Kitagawa, Masashi;Wada, Jun
背景/目的：出血是肾活检后最常见的并发症。虽然有许多出血的预测因素，但动脉僵硬度是否影响出血并发症仍不清楚。方法：我们对在我科进行的约6年（2010年5月至2016年5月）肾活检进行了观察性研究。对临床和实验室因素进行分析，以揭示与出血相关的风险因素，重点是贫血（定义为活检后血红蛋白[Hb]下降>= 10%）。测量臂踝脉搏波速度（baPWV）以评估动脉僵硬度。结果：本研究包括462例患者（男性，n=244;女性，n=218）。在54例患者（11.7%）中观察到贫血（定义见上文）。女性、老年患者以及活检后血清白蛋白、eGFR和舒张压较低的患者发生贫血的风险较高。然后，我们对187例baPWV数据可用的患者进行了进一步分析。多因素分析显示baPWV升高是贫血的独立危险因素。用于预测贫血的ROC分析发现，baPWV值为1839 cm/s具有最佳性能（AUC 0.689）。结论：baPWV增加可能是比任何其他报告的风险因素更有价值的出血预测因子。(C)2017作者由S.发布Karger AG，巴塞尔
Background/Aims: Bleeding is the most common complication after renal biopsy. Although numerous predictors of bleeding have been reported, it remains unclear whether arterial stiffness affects bleeding complications. Method: We performed an observational study of the renal biopsies performed in our division over an approximately 6-year period (May 2010 to May 2016). The clinical and laboratory factors were analyzed to reveal the risk factors associated with bleeding, with a focus on anemia (defined as a >= 10% decrease in hemoglobin [Hb] after biopsy). The brachial-ankle pulse wave velocity (baPWV) was measured to evaluate arterial stiffness. Results: This study included 462 patients (male, n=244; female, n=218). Anemia (defined above) was observed in 54 patients (11.7%). The risk of anemia was higher in women, older patients, and patients with lower serum albumin, lower eGFR and lower diastolic blood pressure after biopsy. We then performed a further analysis of 187 patients whose baPWV data were available. Multivariate analysis revealed that a higher baPWV was an independent risk factor for anemia. ROC analysis for predicting anemia found that a baPWV value of 1839 cm/s had the best performance (AUC 0.689). Conclusion: An increased baPWV may be a more valuable predictor of bleeding than any of the other reported risk factors. (C) 2017 The Author(s) Published by S. Karger AG, Basel