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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (2): 298-301. doi: 10.19723/j.issn.1671-167X.2021.02.011

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Analysis of bleeding risk in percutaneous renal biopsy in Tibet

ZHANG Lei1,LI Guo-liang1,DANG Zong-hui1, 1,A yong1,WU Ling-jie1,LIU Li-jun2,Δ()   

  1. 1. Department of Nephrology, People’s Hospital of Tibet Autonomous Region, Lhasa 850000, China
    2. Renal Division, Institute of Nephrology, Peking University First Hospital, Beijing 100034, China
  • Received:2019-07-16 Online:2021-04-18 Published:2021-04-21
  • Contact: Li-jun LIU E-mail:lijun.liu@aliyun.com

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Abstract:

Objective: To observe the postoperative bleeding after percutaneous renal biopsy (PRB) in Tibet, To analyze and summarize the risk factors associated with bleeding in high altitude patients to improve the safety of surgery. Methods: A retrospective analysis of 150 cases of PRB in the Department of Nephrology, People’s Hospital of Tibet Autonomous Region from May 2016 to May 2018 were carried out, and the correlations between the potential risk factors (gender, age, blood pressure, hemoglobin, platelet, serum creatinine) and postoperative bleeding events were analyzed. Results: During the study period, the 150 patients receiving procedure of PRB were enrolled in our hospital, with an average age of (41.2±15.6) years, of whom 58.7% (88/150) were male, 41.3% (62/150) were female, and major bleeding complications occurred in 12 biopsies (8.0%, 12/150). Six cases for men and women, respectively. The mean age in the bleeding group seemed to be higher than that in the non-bleeding group [(48.3±20.0) years vs. (40.6±15.1) years, P=0.099]. There was no significant difference in the incidence of hypertension, hemoglobinemia, urea nitrogen and prothrombin time between the two groups. The level of serum creatinine in the hemorrhage group seemed to be higher than that in the non-bleeding group (P=0.090), and the time of the hemorrhagic group was longer than that in the non-bleeding group (P=0.069). The platelet count in the bleeding group was significantly lower than that in the non-bleeding group (P<0.05). Multivariate Logistic regression analysis showed that the prolonged activation of partial prothrombin time and lower platelet count had a relatively high risk of bleeding, which was statistically significant (P=0.079, P=0.082). Conclusion: PRB is safe and reliable on the whole in plateau areas; Old age, low platelet count, decreased renal function and prolonged activated partial coagulation time are related to postoperative bleeding of PRB, and hyperhemoglobin is not a risk factor for bleeding. High hemoglobin is not a risk factor for postoperative bleeding of PRB at high altitude.

Key words: Tibet area, Percutaneous renal biopsy, Bleeding complication

CLC Number: 

  • R605

Table 1

Baseline data of bleeding group and non bleeding group"

Items Bleeding group
(n=12)		 Non bleeding group
(n=138)		 P
Gender, male/female 6/12 82/138 0.525
Age/years 48.3±20.0 40.6±15.1 0.099
Dystolic pressure/mmHg 141.4±29.3 132.1±23.8 0.202
Diastolic pressure/mmHg 93.9±19.8 93.2±75.0 0.974
Hypertension, n (%) 8 (66.7) 71 (51.4) 0.311
Hemoglobin/(g/L) 139.6±39.5 141.4±34.0 0.865
HAPC, n (%) 0 (0.0) 4 (2.7) 0.550
Scr/(μmol/L) 175.8±154.4 119.1±106.2 0.090
BUN/(mmol/L) 11.1±10.6 9.1±10.6 0.519
PT/s 13.1±1.5 13.1±3.9 0.940
APTT/s 43.9±7.1 40.1±7.0 0.069
Platelet/(×109/L) 178.5±78.5 226.8±79.3 0.045

Table 2

Logistic analysis of bleeding risk"

Items Multivariate Logistic analysis
OR (95%CI) P
Age 1.02 (0.97-1.07) 0.456
Dystolic pressure 1.00 (0.98-1.03) 0.769
Diastolic pressure 1.00 (0.99-1.01) 0.939
Hemoglobin 1.00 (0.98-1.02) 0.749
Scr 1.00 (1.00-1.01) 0.340
BUN 1.01 (0.93-1.10) 0.861
PT 0.77 (0.45-1.31) 0.331
APTT 1.09 (0.99-1.19) 0.079
Platelet 0.99 (0.98-1.00) 0.082
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