Abstract
Renal biopsy has been widely recommended in clinic to determine the histological patterns of kidney disease. To prevent bleeding complications, patients should routinely stop anticoagulants prior to renal biopsy. However, patients with kidney disease are susceptible to thromboembolisms, particularly in those with severe hypoalbuminemia. This study was designed to investigate the application of serum D-dimer as a predictor for thrombotic events after renal biopsy. 400 consecutive native renal biopsies were prospectively included in this 2-month follow-up study. The overall incidence of bleeding and thrombotic complication is 4%, including hematuria or large perinephric hematoma (2.5%, n = 10) and thrombotic complication (1.5%, n = 6). Compared to low serum D-dimer (<2.00 μg/ml), subjects in the group of high serum D-dimer (≥2.00 μg/ml) were more incline to develop thrombotic complications (9.1% versus 0.3%; RR, 30.33; p < 0.001). D-dimer correlated positively with age (rs = 0.258, P < 0.001). Inverse correlations were found for albumin (rs = −0.339, P < 0.001). Taken together, patients with high serum D-dimer carry an increased risk of thrombotic complications after renal biopsy. Our findings suggest that serum D-dimer can serve as a potential predictor for thrombotic events in patients with kidney disease. Further cautions should be given to these subjects.
Highlights
Percutaneous renal biopsy is an important diagnostic tool to obtain a histological diagnosis for specific patient treatment
There was a cutoff-level for D-dimer as a predictor for thrombotic complications after renal biopsy 2 months, when D-dimer was ≥2.00 μg/ml versus
The aim of our study was to investigate the association between the D-dimer level and the serious thrombotic complication after renal biopsy
Summary
Percutaneous renal biopsy is an important diagnostic tool to obtain a histological diagnosis for specific patient treatment. Some studies have been done on renal biopsies to examine risk factors for biopsy complications Hemorrhage is the most common complication. Patients with kidney disease especially nephrotic syndrome can become hypercoagulable. In these patients, venous thromboembolism ranging from 2% in children to as high as 26.7% in adults and a relative risk of arterial thromboembolism ranging from 1 to 5.5 have been reported . Some patients admitted serious thrombotic complications after renal biopsy. It is important to select the patients who at high risk of thrombotic complication if taken renal biopsy. To our knowledge, no study has examined if D-dimer prior renal biopsy can be used to predict thrombotic complications after renal biopsies
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