Ishikawa et al identified a number of factors associated with significant bleeding after a percutaneous needle biopsy of the kidney. These can help to identify a patient who should be more closely monitored after the procedure. The authors are from Mie University in Japan.


Overt blood loss was defined as a drop in hemoglobin >= 10% by the morning after the procedure (about 16-18 hours afterwards). A percentage drop tended to correlated with clinical status better than an absolute drop in g/dL.


Serious bleeding was defined as the need for blood transfusion or an intervention to control bleeding.


Risk factors for overt blood loss on multivariate analysis:

(1) perirenal hematoma >= 2 cm by ultrasonography performed 10 minutes after the procedure (odds ratio 8.1)

(2) INR > 1.0 (odds ratio 2.5)

(3) mean blood pressure >= 105 mm Hg (odds ratio 2.5)

(4) history of corticosteroid therapy (odds ratio 2.6)



• The mean blood pressure is ((systolic) + (2 * (diastolic))) / 3.


Additional risk factors that may contribute:

(1) older age

(2) serum creatinine >= 2.0 mg/dL


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