Risk Factors Related to Hemorrhage Necessitating Renal Artery Embolization after Percutaneous Nephrostomy

Abstract

동맥경화, 고령, 고혈압, 당뇨와 함께 결절다발동맥염과 같은 혈 Purpose: To investigate risk factors related to severe bleeding necessitating renal artery embolization (RAE) after percutaneous nephrostomy (PCN). Materials and Methods: 36 patients who underwent RAE from January 2005 to June 2014 were retrospectively reviewed. Among them, 10 patients underwent embolization because of severe bleeding after PCN (bleeding group). From 1762 patients who underwent PCN in the same period, we selected 21 patients who underwent PCN without bleeding after the procedure (non-bleeding group). We investigated possible related risk factors, such as the presence of underlying diseases, activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, puncture site, procedure time, size of the kidney, distance from skin to renal cortex, maximum caliber of the indwelling catheter, parenchymal thickness, and grade of hydronephrosis. We used Fisher’s exact test and independent t test for data analyses. Results: We classified hydronephrosis as either ‘mild hydronephrosis,’ or ‘moderate or severe hydronephrosis.’ The frequency of mild hydronephrosis was 80.0% (8/10) in the bleeding group and 33.3% (7/21) in the non-bleeding group (p = 0.023). There were no significant differences between the two groups in the incidence of underlying diseases. Similarly, other risk factors (PT, aPTT, platelet count, procedure time, distance from skin to renal cortex, maximum caliber of the indwelling catheter, kidney size, and parenhcymal thickness) also did not differ significantly between the two groups. Conclusion: Mild hydronephrosis is a risk factor for severe bleeding necessitating RAE after PCN. Therefore, when performing PCN, careful attention should be paid to patients with mild hydronephrosis. Index terms Percutaneous Nephrostomy Bleeding Renal Artery Embolization, Therapeutic Hydronephrosis