Peters Björn, Nasic Salmir, Segelmark Mårten
Department of Nephrology, Skaraborg Hospital, Skövde, Sweden.
Department of Public Health and Clinical Medicine, Umeå University, Umea, Sweden.
Clin Kidney J. 2019 Oct 19;13(4):654-659. doi: 10.1093/ckj/sfz132. eCollection 2020 Aug.
Renal biopsies are essential in nephrology but they are invasive and complications can occur. The aim of this study was to explore clinical parameters that can be used as predictors for biopsy complications.
Clinical parameters such as demographics, biopsy indications, serology, comorbidities and clinical chemistry were retrieved from a regional biopsy registry between 2006 and 2015 and from a nationwide registry between 2015 and 2017. Clinical data before biopsy were compared with data on major biopsy complications. Fisher's exact and tests were used and odds ratios (ORs) with 95% confidence intervals (CIs) were presented. Univariate and multiple binary logistic regression analyses were performed with complications as outcome. A two-sided P-value <0.05 was considered significant.
In total, 2835 consecutive native kidney biopsies were analysed (39% women and 61% men, median age 57 years). No death and nephrectomy due to biopsy complications were registered. The frequency of major biopsy complications was 5.65%. In the multiple logistic regression, the risk for complications increased in women [OR 1.51 (95% CI 1.08-2.11)] and decreased with age: 45-64 years age group [OR 0.66 (95% CI 0.44-0.99)] and >74 years age group [OR 0.51 (95% CI 0.27-0.96)]. Among comorbidities, patients with diabetes mellitus type 2 [OR 2.07 (95% CI 1.15-3.72)] and non-ischaemic heart disease [OR 3.20 (95% CI 1.64-6.25)] had a higher risk for major biopsy complications.
Female gender, younger age (≤44 years), diabetes mellitus type 2 and non-ischaemic heart disease were found as risk factors for major biopsy complications.
肾活检在肾脏病学中至关重要，但具有侵入性且可能发生并发症。本研究的目的是探索可作为活检并发症预测指标的临床参数。
从2006年至2015年的地区活检登记处以及2015年至2017年的全国登记处获取人口统计学、活检指征、血清学、合并症和临床化学等临床参数。将活检前的临床数据与主要活检并发症的数据进行比较。使用Fisher精确检验和卡方检验，并给出比值比（OR）及其95%置信区间（CI）。以并发症为结局进行单因素和多因素二元逻辑回归分析。双侧P值<0.05被认为具有统计学意义。
共分析了2835例连续的自体肾活检病例（女性占39%，男性占61%，中位年龄57岁）。未记录到因活检并发症导致的死亡和肾切除术。主要活检并发症的发生率为5.65%。在多因素逻辑回归中，女性并发症风险增加[OR 1.51（95%CI 1.08 - 2.11）]，且随年龄增长而降低：45 - 64岁年龄组[OR 0.66（95%CI 0.44 - 0.99）]和>74岁年龄组[OR 0.51（95%CI 0.27 - 0.96）]。在合并症中，2型糖尿病患者[OR 2.07（95%CI 1.15 - 3.72）]和非缺血性心脏病患者[OR 3.20（95%CI 1.64 - 6.25）]发生主要活检并发症的风险更高。
女性、较年轻年龄（≤44岁）、2型糖尿病和非缺血性心脏病被发现是主要活检并发症的危险因素。
